Provider Demographics
NPI:1073563896
Name:DICKENSON COUNTY HOME HEALTH & HOSPICE, INC
Entity Type:Organization
Organization Name:DICKENSON COUNTY HOME HEALTH & HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-926-6600
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:CLINTWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24228-1187
Mailing Address - Country:US
Mailing Address - Phone:276-926-6600
Mailing Address - Fax:276-926-6783
Practice Address - Street 1:230 CHASE ST
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228-5991
Practice Address - Country:US
Practice Address - Phone:276-926-6600
Practice Address - Fax:276-926-6783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010194181Medicaid
VA010194181Medicaid