Provider Demographics
NPI:1326558727
Name:HOME CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:HOME CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:NICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-677-0223
Mailing Address - Street 1:6834 COLEMANS CROSSING AVE STE E
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-3337
Mailing Address - Country:US
Mailing Address - Phone:804-210-1333
Mailing Address - Fax:804-210-1550
Practice Address - Street 1:6834 COLEMANS CROSSING AVE STE E
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3337
Practice Address - Country:US
Practice Address - Phone:804-210-1333
Practice Address - Fax:804-210-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
VAHCO-1812943747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty