Organization
TEAM NURSE, INC.
Active
Other names
Care Advantage, Team Nurse South Boston, Care Advantage, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY ROYSTER (SR ACCOUNTING MANAGER)
(804) 323-9464
Entity
Organization
Contact information
Practice address
3352 HALIFAX RD, SOUTH BOSTON, VA 24592-4842
(434) 517-0050
(434) 517-0049
Mailing address
PO BOX 776, SOUTH BOSTON, VA 24592-0776
(434) 575-5200
(434) 575-5204
Taxonomy
Speciality
Code
Description
License number
State
163WC2100X
Continence Care Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
HCO-0992
VA
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008704031
—
VA
01
—
008751129
MEDICAID PRIVATE DUTY NURSING
VA
05
—
008771685
—
VA
01
—
HCO-0992
STATE LICENSURE
VA
01
—
ML-171464
COMMONWEALTH OF VIRGINIA VDH
VA
Enumeration date
10/25/2006
Last updated
03/08/2023
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