# BLAKE HOME HEALTH AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blake Home Health Agency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215457254
- **Authorized official:** MRS. DIONNE JACKSON (DIRECTOR)
- **Authorized official phone:** (804) 545-1974

## Contact information

- **Practice address:** 11815 FOUNTAIN WAY STE 300, NEWPORT NEWS, VA 23606-4448
- **Practice address phone:** (757) 926-5241
- **Practice address fax:** (888) 314-9510
- **Mailing address:** 5709 S LABURNUM AVE, RICHMOND, VA 23231-4420
- **Mailing address phone:** (804) 545-1974
- **Mailing address fax:** (888) 314-9510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | HCO171615 | VA | Yes |
| 385H00000X | Respite Care | HCO171615 | VA | — |

## Other

- **Enumeration date:** 06/21/2017
- **Last updated:** 08/14/2019