Organization
MANIFEST TOTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUNTAH POWELL (OFFICE ADMINISTRATOR)
(804) 300-5112
Entity
Organization
Contact information
Practice address
3001 QUARTER CREEK LN, #4, RICHMOND, VA 23294-5215
(804) 300-5664
Mailing address
3001 QUARTER CREEK LN, #4, RICHMOND, VA 23294-5215
(804) 300-5664
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/30/2015
Last updated
01/11/2016
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