Organization
HEALTHCARE SERVICES 101
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAQUEL MONTRELL HARRIS RN (CEO)
(757) 809-3588
Entity
Organization
Contact information
Practice address
204 E. WASHINGTON ST, SUFFOLK, VA 23434-4514
(757) 809-3588
Mailing address
PO BOX 5588, SUFFOLK, VA 23435-0588
(757) 809-3588
(757) 809-3599
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
0001159829
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159939617
—
VA
05
—
0159940029
—
VA
Enumeration date
07/30/2010
Last updated
07/30/2010
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