Provider Demographics
NPI:1396209896
Name:ELDERCARE LLC
Entity Type:Organization
Organization Name:ELDERCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PPPRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-651-6718
Mailing Address - Street 1:6767 FOREST HILL AVE STE 218
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1851
Mailing Address - Country:US
Mailing Address - Phone:804-651-6718
Mailing Address - Fax:877-546-0675
Practice Address - Street 1:6767 FOREST HILL AVE STE 218
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1851
Practice Address - Country:US
Practice Address - Phone:804-651-6718
Practice Address - Fax:877-546-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health