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General NPI Number Information
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NPI Number | 1912423179
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Entity Type | Organization
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Legal Business Name | ADVOQUATE HEALTH SERVICES
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Dates
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Enumeration Date | 08/19/2017
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Last Update Date | 08/19/2017
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Provider Practice Location Address
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Address Line | 4870 SADLER RD # 310
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6294
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Country | US
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Telephone | 804-386-4058
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Fax |
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Provider Business Mailing Address
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Address Line | 12306 QUAIL OAK CT
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City | ASHLAND
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State | VA
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Zip | 23005-7871
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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 | DIRECTOR OF NURSING
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Name | MRS. BESSEM OJONG ADESO
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Credential | RN
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Telephone | 804-386-4058
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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 |
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License Number State |
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