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Organization

BEDROCK AT HOME VIRGINIA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRYSTLE KELHOFFER (DIRECTOR OF OPERATIONS)
(757) 916-7350
Entity
Organization

Contact information

Practice address
3709 SHANNONS GREEN WAY # 309, ALEXANDRIA, VA 22309-3659
(757) 916-7350
Mailing address
3709 SHANNONS GREEN WAY # 309, ALEXANDRIA, VA 22309-3659
(757) 916-7350

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
372500000X
Chore Provider
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
374U00000X
Home Health Aide
Primary
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Enumeration date
10/25/2023
Last updated
10/25/2023
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