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General NPI Number Information
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NPI Number | 1790309540
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Entity Type | Organization
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Legal Business Name | SHADES OF LIFE HOME CARE SERVICES,LLC
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Dates
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Enumeration Date | 06/07/2020
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 138 S ROSEMONT RD STE 211
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4336
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Country | US
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Telephone | 757-672-3507
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Fax | 757-210-9481
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Provider Business Mailing Address
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Address Line | 2201 BAGELWOOD CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6897
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Country | US
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Telephone | 757-672-3507
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Fax | 757-210-9481
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. DIONNE CHOLE GIBBS
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Credential | NURSE
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Telephone | 757-672-3507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 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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