Provider Demographics
NPI:1548722622
Name:HOME HEALTH PLUS OF VIRGINIA, LLC
Entity type:Organization
Organization Name:HOME HEALTH PLUS OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:434-242-8077
Mailing Address - Street 1:1924 ARLINGTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-1533
Mailing Address - Country:US
Mailing Address - Phone:540-505-8487
Mailing Address - Fax:434-984-0330
Practice Address - Street 1:1924 ARLINGTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-1533
Practice Address - Country:US
Practice Address - Phone:540-505-8487
Practice Address - Fax:434-295-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1659753242Medicaid