Organization
BLAKE HOME HEALTHCARE, LLC
Active
Other names
Blake Home Healthcare, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MONTEL MAYO (DIRECTOR/PRESIDENT)
(804) 545-1974
Entity
Organization
Contact information
Practice address
5709 S LABURNUM AVE, RICHMOND, VA 23231-4420
(804) 545-1974
Mailing address
3524 CARTER RD, PORTSMOUTH, VA 23703-3811
(757) 637-5073
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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