Organization
360 HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKA SHELTON (PARTNER)
(804) 761-7351
Entity
Organization
Contact information
Practice address
6400 MECHANICSVILLE TPKE, MECHANICSVILLE, VA 23111-4579
(804) 761-7351
Mailing address
290 THE LEVEL, TAPPAHANNOCK, VA 22560-5959
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HCO-161323
VA
251J00000X
Nursing Care Agency
HCO-161323
VA
385H00000X
Respite Care
Primary
HCO-161323
VA
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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