Organization
PROFESSIONAL FOUNDATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESA Y BROWN REGISTER NURSE (ADMINISTRATOR)
(804) 358-5858
Entity
Organization
Contact information
Practice address
4410 CLAIBORNE SQ E STE 334, HAMPTON, VA 23666-2074
(804) 358-5858
Mailing address
8224 SIR LIONEL PL, NORTH CHESTERFIELD, VA 23237-4725
(804) 358-5858
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
06/02/2020
Last updated
10/30/2020
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