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General NPI Number Information
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NPI Number | 1821310624
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Entity Type | Organization
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Legal Business Name | HANOVER HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 9291 LAUREL GROVE RD STE 104
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2947
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Country | US
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Telephone | 804-569-6340
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Fax | 804-569-6342
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Provider Business Mailing Address
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Address Line | 9291 LAUREL GROVE RD STE 104
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2947
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Country | US
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Telephone | 804-569-6340
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Fax | 804-569-6342
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MRS. ARLENE W HODGES
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Credential | BSN
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Telephone | 804-746-9019
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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 | HCO10609
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License Number State | VA
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