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General NPI Number Information
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NPI Number | 1841503836
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Entity Type | Organization
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Legal Business Name | ALABASTER ANOINTED HOME CARE
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 50 GRANGER DR
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City | HAMPTON
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State | VA
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Zip | 23666-4633
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Country | US
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Telephone | 757-826-1116
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Fax | 757-825-0257
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Provider Business Mailing Address
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Address Line | 50 GRANGER DR
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City | HAMPTON
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State | VA
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Zip | 23666-4633
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Country | US
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Telephone | 757-826-1116
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Fax | 757-825-0257
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARTINIQUE MERCEDES BOSIER
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Credential | MA
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Telephone | 757-826-1116
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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 | 117065
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License Number State | VA
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