Organization
D-VINE GRACE HOME HEALTH CARE LLC
Active
Other names
Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICKY CHARLES (CEO/OWNER)
(757) 673-0796
Entity
Organization
Contact information
Practice address
114 CHOWAN DR, A, PORTSMOUTH, VA 23701-2452
(757) 673-0796
Mailing address
114 CHOWAN DR, A, PORTSMOUTH, VA 23701-2452
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-161264
VA
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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