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Organization
EASTERN SHORE AREA AGENCY ON AGING/COMMUNITY ACTION AGENCY
Active
Organization
EASTERN SHORE AREA AGENCY ON AGING/COMMUNITY ACTION AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE MUSSO (CEO)
(757) 442-9652
Entity
Organization
Contact information
Practice address
5432 BAYSIDE RD, EXMORE, VA 23350-3936
(757) 442-9652
(757) 442-9303
Mailing address
5432 BAYSIDE RD, EXMORE, VA 23350-3936
(757) 442-9652
(757) 442-9303
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-15709
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0087005085
—
VA
05
—
0163372003
—
VA
05
—
0167908513
—
VA
Enumeration date
11/17/2014
Last updated
11/17/2014
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