MEDICARE: ENCHANTED HANDS HOME HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385H00000X	Respite Care
2	3747P1801X	Personal Care Attendant
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1306605191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCHANTED HANDS HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4217 HIGH TIDE WAY
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-3349
Country	:	US
Telephone Number	:	757-610-1832
Fax Number	:	757-998-8250

Provider Business Practice Location Address
First Line	:	4217 HIGH TIDE WAY
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-3349
Country	:	US
Telephone Number	:	757-751-3824
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATOYA BURDEN
Credential	:
Telephone Number	:	757-751-3824

Provider Enumeration Date	:	03/15/2024
Last Update Date	:	09/03/2025

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