Organization
SAFE AT HOME SERVICE FACILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON Y MASON RN (ADMINISTRATOR)
(571) 316-8039
Entity
Organization
Contact information
Practice address
1467 CHESTERFIELD RD, LOCUST GROVE, VA 22508-3131
(571) 316-8039
(540) 369-3538
Mailing address
1467 CHESTERFIELD RD, LOCUST GROVE, VA 22508-3131
(571) 316-8039
(540) 369-3538
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017679990001
—
VA
01
—
HCO-0005123
COMMON WEALTH VIRGINIA DEPARTMENT OF HEALTH
VA
Enumeration date
09/12/2023
Last updated
02/15/2024
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