Organization
BLAKE HOME HEALTH AGENCY
Active
Other names
Blake Home Health Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIONNE JACKSON (DIRECTOR)
(804) 545-1974
Entity
Organization
Contact information
Practice address
11815 FOUNTAIN WAY STE 300, NEWPORT NEWS, VA 23606-4448
(757) 926-5241
(888) 314-9510
Mailing address
5709 S LABURNUM AVE, RICHMOND, VA 23231-4420
(804) 545-1974
(888) 314-9510
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HCO171615
VA
385H00000X
Respite Care
HCO171615
VA
Other
Enumeration date
06/21/2017
Last updated
08/14/2019
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