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General NPI Number Information
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NPI Number | 1770233140
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Entity Type | Organization
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Legal Business Name | MID-ATLANTIC HOME CARE RICHMOND, LLC
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 4900 COX RD STE 245
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6509
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Country | US
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Telephone | 804-527-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 COX RD STE 245
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6509
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Country | US
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Telephone | 804-527-1100
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KELLY CRISTE-COOK
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Credential |
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Telephone | 804-527-1100
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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 |
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License Number State |
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Taxonomy #2
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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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