MEDICARE: ALL-4-ONE HOME HEALTHCARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	0001140411	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001140411	OTHER	VA	VIRGINIA RN LICENSE

General Provider Information

NPI Number	:	1043672397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL-4-ONE HOME HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	1629 SALEM RD
Second Line	:	SUITE 101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-5494
Country	:	US
Telephone Number	:	757-962-7838
Fax Number	:	757-962-5759

Provider Business Practice Location Address
First Line	:	1629 SALEM RD
Second Line	:	SUITE 101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-5494
Country	:	US
Telephone Number	:	757-962-7838
Fax Number	:	757-962-5759

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. EESPERANZA FORONDA
Credential	:	R.N.
Telephone Number	:	757-962-7838

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	03/25/2016

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