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Organization

PATIENT CENTERED CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARVELLE JACKSON (ADMINISTRATOR ASSISTANT)
(757) 397-0843
Entity
Organization

Contact information

Practice address
808 LOUDOUN AVE, STE 1, PORTSMOUTH, VA 23707-3234
(757) 397-0843
(757) 397-0849
Mailing address
808 LOUDOUN AVE, STE 1, PORTSMOUTH, VA 23707-3234
(757) 397-0843
(757) 397-0849

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-13950
VA

Other

Enumeration date
04/13/2013
Last updated
08/13/2013
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