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General NPI Number Information
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NPI Number | 1902618465
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Entity Type | Organization
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Legal Business Name | ELITE HAVEN HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 13 SHARON LN
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City | STAFFORD
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State | VA
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Zip | 22554-7888
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Country | US
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Telephone | 571-230-4109
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Fax |
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Provider Business Mailing Address
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Address Line | 13 SHARON LN
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City | STAFFORD
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State | VA
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Zip | 22554-7888
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, VICE PRESIDENT
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Name | VERONICA PINCKNEY
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Credential |
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Telephone | 571-230-4109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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