Provider Demographics
NPI:1306204904
Name:CENTRAL VIRGINIA HOME CARE, LLC
Entity Type:Organization
Organization Name:CENTRAL VIRGINIA HOME CARE, LLC
Other - Org Name:SENIORCORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:757-679-2805
Mailing Address - Street 1:PO BOX 66884
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23466-6884
Mailing Address - Country:US
Mailing Address - Phone:877-444-4112
Mailing Address - Fax:
Practice Address - Street 1:413 STUART CIR
Practice Address - Street 2:SUITE 120
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3741
Practice Address - Country:US
Practice Address - Phone:877-444-4112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-161403253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care