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Organization
BLAKE HOME HEALTH AGENCY
Active
Organization
BLAKE HOME HEALTH AGENCY
Active
Other names
Blake Home Health Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIONNE JACKSON (DIRECTOR)
(804) 545-1974
Entity
Organization
Contact information
Practice address
11815 FOUNTAIN WAY STE 300, NEWPORT NEWS, VA 23606-4448
(757) 926-5241
(888) 314-9510
Mailing address
5709 S LABURNUM AVE, RICHMOND, VA 23231-4420
(804) 545-1974
(888) 314-9510
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HCO171615
VA
385H00000X
Respite Care
HCO171615
VA
Other
Enumeration date
06/21/2017
Last updated
08/14/2019
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