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NPI 1659854990

NPI 1659854990 : STANLEY PERSONAL TOUCH IN-HOME CARE SERVICES, INC : SUFFOLK, VA

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General NPI Number Information
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    NPI Number           |    1659854990
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    Entity Type          |    Organization 
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    Legal Business Name  |    STANLEY PERSONAL TOUCH IN-HOME CARE SERVICES, INC 
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Dates
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    Enumeration Date     |    09/12/2018
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    Last Update Date     |    09/12/2018
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Provider Practice Location Address
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    Address Line         |    100 PARK RD 
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    City                 |    SUFFOLK
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    State                |    VA
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    Zip                  |    23434-6220
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    Country              |    US
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    Telephone            |    757-364-5643
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    Fax                  |    757-578-9268
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Provider Business Mailing Address
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    Address Line         |    100 PARK RD 
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    City                 |    SUFFOLK
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    State                |    VA
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    Zip                  |    23434-6220
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    Country              |    US
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    Telephone            |    757-364-5643
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. WILLIE LAMONT BEALE 
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    Credential           |    
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    Telephone            |    757-364-5643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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