# EASTERN SHORE AREA AGENCY ON AGING/COMMUNITY ACTION AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356747588
- **Authorized official:** MS. DIANE MUSSO (CEO)
- **Authorized official phone:** (757) 442-9652

## Contact information

- **Practice address:** 5432 BAYSIDE RD, EXMORE, VA 23350-3936
- **Practice address phone:** (757) 442-9652
- **Practice address fax:** (757) 442-9303
- **Mailing address:** 5432 BAYSIDE RD, EXMORE, VA 23350-3936
- **Mailing address phone:** (757) 442-9652
- **Mailing address fax:** (757) 442-9303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO-15709 | VA | Yes |

## Other

- **Enumeration date:** 11/17/2014
- **Last updated:** 11/17/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0087005085 | — | VA |
| 05 | — | 0163372003 | — | VA |
| 05 | — | 0167908513 | — | VA |