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Organization

LILLIES IN THE VALLEY PRIVATE DUTY SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YVETTE VONCENT MIX CERTIFIED NURSE AIDE (OWNER)
(757) 873-0711
Entity
Organization

Contact information

Practice address
546 DENBIGH BLVD, SUITE C, NEWPORT NEWS, VA 23608-4240
(757) 873-0711
(757) 873-0744
Mailing address
546 DENBIGH BLVD, SUITE C, NEWPORT NEWS, VA 23608-4240
(757) 873-0711
(757) 873-0744

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-09332
VA
251E00000X
Home Health Agency
HCO07332
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0102419873
VA
05
0102510952
VA
05
010354901
VA
Enumeration date
11/24/2006
Last updated
12/05/2008
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