Organization
COMPANION EXTRAORDINAIRE NURSING NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN L BENINGHOVE (OWNER/DIRECTOR)
(804) 752-2205
Entity
Organization
Contact information
Practice address
112 ENGLAND ST, ASHLAND, VA 23005-2083
(804) 752-2205
(804) 752-3403
Mailing address
112 ENGLAND ST, ASHLAND, VA 23005-2083
(804) 752-2205
(804) 752-3403
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0715000070
VA
251J00000X
Nursing Care Agency
0715000070
VA
253Z00000X
In Home Supportive Care Agency
0715000070
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159264222
—
VA
Enumeration date
01/27/2012
Last updated
01/27/2012
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