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Organization
SENIOR HOME SHARE, LLC
Active
Organization
SENIOR HOME SHARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE D. FOX (SOLE MEMBER)
(276) 238-1448
Entity
Organization
Contact information
Practice address
1002 E STUART DR STE 3, GALAX, VA 24333-2664
(276) 238-1448
(276) 601-2587
Mailing address
1002 E STUART DR STE 3, GALAX, VA 24333-2664
(276) 238-1448
(276) 601-2587
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E24637778
DRIVER'S LICENSE
VA
Enumeration date
02/27/2019
Last updated
02/27/2019
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