Organization
MY HOME FOR LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES IX (MANAGER)
(434) 977-6435
Entity
Organization
Contact information
Practice address
1300 BRANCHLANDS DR, CHARLOTTESVILLE, VA 22901-1783
(434) 977-6435
Mailing address
1300 BRANCHLANDS DR, CHARLOTTESVILLE, VA 22901-1783
(434) 977-6435
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2400344
VA
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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