Provider Demographics
NPI:1003213885
Name:I AM COMPANION HOME CARE, LLC
Entity Type:Organization
Organization Name:I AM COMPANION HOME CARE, LLC
Other - Org Name:IAMCHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-644-8053
Mailing Address - Street 1:813 FORREST DR STE 1
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4513
Mailing Address - Country:US
Mailing Address - Phone:757-599-0093
Mailing Address - Fax:757-599-0095
Practice Address - Street 1:813 FORREST DR STE 1
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4513
Practice Address - Country:US
Practice Address - Phone:757-599-0093
Practice Address - Fax:757-599-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-23
Last Update Date:2014-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO151232251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health