MEDICARE: DOLLIE AND CLARA HOME HEALTHCARE

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	251E00000X	Home Health Agency		VA

General Provider Information

NPI Number	:	1699252676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLLIE AND CLARA HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	5383 LEICESTER CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3539
Country	:	US
Telephone Number	:	757-230-0021
Fax Number	:

Provider Business Practice Location Address
First Line	:	5383 LEICESTER CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3539
Country	:	US
Telephone Number	:	757-230-0021
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONAL MANAGER/ADMINISTRATOR
Name	:	LATORSHA MARIE DUNN
Credential	:
Telephone Number	:	757-230-0021

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	07/23/2018

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