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General NPI Number Information
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NPI Number | 1740253889
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Entity Type | Organization
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Legal Business Name | COMPANION EXTRAORDINAIRE NURSING NETWORK, INC.
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 130 THOMPSON ST
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City | ASHLAND
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State | VA
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Zip | 23005-1526
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Country | US
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Telephone | 804-752-2205
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Fax | 804-725-3403
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Provider Business Mailing Address
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Address Line | 130 THOMPSON ST
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City | ASHLAND
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State | VA
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Zip | 23005-1526
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Country | US
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Telephone | 804-752-2205
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Fax | 804-725-3403
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MRS. JONI FA NON BORELL
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Credential | RN
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Telephone | 804-752-2205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-331
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License Number State | VA
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