Organization
INDEPENDENT SENIOR HOME SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACEY N PHILLIPS CERTIFIED NURSE AIDE (OWNER)
(757) 478-3884
Entity
Organization
Contact information
Practice address
4599 QUAKER DR, SUFFOLK, VA 23437-9026
(757) 478-3884
Mailing address
4599 QUAKER DR, SUFFOLK, VA 23437-9026
(757) 478-3884
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2008-237117-R
VA
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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