Provider Demographics
NPI:1225601503
Name:ARDENS HOMECARE AND MEDICAL STAFFING
Entity Type:Organization
Organization Name:ARDENS HOMECARE AND MEDICAL STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-895-7955
Mailing Address - Street 1:523 LAWFORD LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-5542
Mailing Address - Country:US
Mailing Address - Phone:804-513-0446
Mailing Address - Fax:
Practice Address - Street 1:300 TURNER RD STE F-H
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-6431
Practice Address - Country:US
Practice Address - Phone:804-895-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health