Blake Home Health Agency
In Home Supportive Care in Newport News, VA. Organization (NPI-2).
NPI number1215457254
StatusActive
Last updated in NPPESAug 14, 2019
Details
- NPI
- 1215457254
- Entity type
- Organization (NPI-2)
- Legal business name
- Blake Home Health Agency
- Organization subpart
- No
- Enumeration date
- Jun 21, 2017
- Last updated
- Aug 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | HCO171615 | VA | Yes |
| 385H00000X | Respite Care | HCO171615 | VA |
Other names
- Blake Home Health Agency (Other Name)
Practice location
11815 Fountain Way Ste 300Newport News, VA 23606-4448
Phone 757-926-5241 · Fax 888-314-9510
Mailing address
5709 S Laburnum AveRichmond, VA 23231-4420
Phone 804-545-1974 · Fax 888-314-9510
Authorized official
Dionne Jackson
Director
8045451974
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