Provider Demographics
NPI:1265476626
Name:HOME RECOVERY OF VIRGINIA, LLC
Entity Type:Organization
Organization Name:HOME RECOVERY OF VIRGINIA, LLC
Other - Org Name:HOME RECOVERY - HOMEAID
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-315-5222
Mailing Address - Street 1:816 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-1608
Mailing Address - Country:US
Mailing Address - Phone:434-392-7336
Mailing Address - Fax:434-392-1970
Practice Address - Street 1:816 E 3RD ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1608
Practice Address - Country:US
Practice Address - Phone:434-392-7336
Practice Address - Fax:434-392-1970
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME RECOVERY-HOMEAID, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-16
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0087702632Medicaid
VA0087440258Medicaid
VA0087020985Medicaid