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Organization

HEALTHCARE SERVICES 101, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RAQUEL MONTRELL HARRIS RN, BSN (ADMINISTRATOR)
(757) 809-3588
Entity
Organization

Contact information

Practice address
125 TYNES ST, SUFFOLK, VA 23434-4624
(757) 809-3588
(757) 809-3599
Mailing address
125 TYNES ST, SUFFOLK, VA 23434-4624
(757) 809-3588
(757) 809-3599

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
HCO-13859
VA
251E00000X
Home Health Agency
HCO-13859
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0159939617
VA
05
0159940029
VA
Enumeration date
07/30/2012
Last updated
12/02/2014
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