Provider Demographics
NPI:1235701517
Name:COMPLETE CARE FOR KIDS
Entity Type:Organization
Organization Name:COMPLETE CARE FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:ROZANSKI
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-223-5437
Mailing Address - Street 1:13204 HULL STREET RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2620
Mailing Address - Country:US
Mailing Address - Phone:804-223-5437
Mailing Address - Fax:804-999-0369
Practice Address - Street 1:13204 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2620
Practice Address - Country:US
Practice Address - Phone:804-223-5437
Practice Address - Fax:804-999-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1659385987Medicaid
VA1932318912Medicaid