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Organization
LILLIES IN THE VALLEY PRIVATE DUTY SERVICES, LLC
Active
Organization
LILLIES IN THE VALLEY PRIVATE DUTY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVETTE VONCENT MIX CERTIFIED NURSE AIDE (OWNER)
(757) 873-0711
Entity
Organization
Contact information
Practice address
546 DENBIGH BLVD, SUITE C, NEWPORT NEWS, VA 23608-4240
(757) 873-0711
(757) 873-0744
Mailing address
546 DENBIGH BLVD, SUITE C, NEWPORT NEWS, VA 23608-4240
(757) 873-0711
(757) 873-0744
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-09332
VA
251E00000X
Home Health Agency
HCO07332
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102419873
—
VA
05
—
0102510952
—
VA
05
—
010354901
—
VA
Enumeration date
11/24/2006
Last updated
12/05/2008
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