Organization
CLINICA IMPERIAL, LLC
Active
Other names
Caregistics
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SIMON (OWNER)
(804) 833-2900
Entity
Organization
Contact information
Practice address
6413 HACKNEY CIR, NORTH CHESTERFIELD, VA 23234-4573
(804) 833-2900
Mailing address
9453 AMBERDALE DR, NORTH CHESTERFIELD, VA 23236-1249
(804) 447-9540
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/27/2015
Last updated
11/14/2018
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