Provider Demographics
NPI:1043237845
Name:ALL CARE HOME HEALTH
Entity Type:Organization
Organization Name:ALL CARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MATHENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-836-5883
Mailing Address - Street 1:242 NOR DAN DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1612
Mailing Address - Country:US
Mailing Address - Phone:434-836-5883
Mailing Address - Fax:434-836-0254
Practice Address - Street 1:242 NOR DAN DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1612
Practice Address - Country:US
Practice Address - Phone:434-836-5883
Practice Address - Fax:434-836-0254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002046838251E00000X
VA0001121009251E00000X
VA0001141653251E00000X
VA2305002760251E00000X
VA2305002761251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4970306Medicaid
VA4970306Medicaid