Organization
PERSONAL HOMECARE, INC.
Active
Other names
1st Care At Home
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED LEE BURKHOLDER III (PRESIDENT/CEO)
(434) 572-1582
Entity
Organization
Contact information
Practice address
425 MAIN ST, SOUTH BOSTON, VA 24592-3241
(434) 572-1028
Mailing address
PO BOX 1006, SOUTH BOSTON, VA 24592-1006
(434) 572-1028
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
—
—
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
8702594
VA
333300000X
Emergency Response System Companies
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8702411
—
VA
05
—
8702594
—
VA
05
—
8704368
—
VA
05
—
8751013
—
VA
05
—
8751111
—
VA
05
—
8751498
—
VA
05
—
8771677
—
VA
05
—
8771693
—
VA
05
—
8773289
—
VA
05
—
9106235
—
VA
05
—
9106251
—
VA
05
—
9119868
—
VA
Enumeration date
03/13/2015
Last updated
11/20/2023
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