# KARLISE IN-HOME CARE, LLC

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

## Provider details

- **NPI number:** 1972730927
- **Authorized official:** MRS. AMANDA MOYE RANDOLPH (CEO/PRESIDENT)
- **Authorized official phone:** (434) 842-2800

## Contact information

- **Practice address:** 6774 JAMES MADISON HWY, SUITE 400, FORK UNION, VA 23055-2084
- **Practice address phone:** (434) 842-2800
- **Practice address fax:** (434) 842-2801
- **Mailing address:** PO BOX 703, FORK UNION, VA 23055-0703
- **Mailing address phone:** (434) 842-2800
- **Mailing address fax:** (434) 842-2801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO-09578 | VA | Yes |

## Other

- **Enumeration date:** 06/17/2009
- **Last updated:** 06/17/2009