Organization
IN HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE WHITAKER (SECRETARY CORP)
(276) 329-9340
Entity
Organization
Contact information
Practice address
201 NOTTINGHAM AVE, WISE, VA 24293-5612
(276) 329-9340
Mailing address
201 NOTTINGHAM AVE, WISE, VA 24293-5612
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251J00000X
Nursing Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010015324
—
VA
05
—
4971051
—
VA
05
—
8701768
—
VA
05
—
8702101
—
VA
05
—
8702861
—
VA
05
—
8740399
—
VA
05
—
8742049
—
VA
05
—
8743541
—
VA
05
—
8743584
—
VA
05
—
8751234
—
VA
05
—
8771758
—
VA
05
—
8771987
—
VA
05
—
9600019
—
VA
05
—
9600167
—
VA
Enumeration date
07/18/2006
Last updated
02/26/2018
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