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General NPI Number Information
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NPI Number | 1831795087
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Entity Type | Organization
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Legal Business Name | A DIFFERENT CLOCK AGENCY LLC
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1039 JACKSON AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23324-2416
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Country | US
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Telephone | 757-676-2986
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Fax |
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Provider Business Mailing Address
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Address Line | 1039 JACKSON AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23324-2416
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Country | US
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Telephone | 757-676-2986
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OTELIA M MCFARLAND
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Credential |
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Telephone | 757-676-2986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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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