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General NPI Number Information
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NPI Number | 1831445626
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Entity Type | Organization
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Legal Business Name | HEALTHCARE SERVICES 101, LLC
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 125 TYNES ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4624
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Country | US
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Telephone | 757-809-3588
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Fax | 757-809-3599
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Provider Business Mailing Address
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Address Line | 125 TYNES ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4624
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Country | US
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Telephone | 757-809-3588
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Fax | 757-809-3599
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. RAQUEL MONTRELL HARRIS
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Credential | RN, BSN
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Telephone | 757-809-3588
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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-13859
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | HCO-13859
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License Number State | VA
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