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Organization
PHENOMENAL HOME CARE SERVICES
Active
Organization
PHENOMENAL HOME CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INGRID DARLETTE FRASER (ADMINISTRATOR)
(757) 937-2357
Entity
Organization
Contact information
Practice address
405 S PARLIAMENT DR STE 201, VIRGINIA BEACH, VA 23462-6311
(757) 937-2357
Mailing address
405 S PARLIAMENT DR STE 201, VIRGINIA BEACH, VA 23462-6311
(757) 937-2357
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
Other
Enumeration date
03/28/2019
Last updated
11/20/2023
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