Provider Demographics
NPI:1396839312
Name:PERSONAL HOMECARE INC
Entity Type:Organization
Organization Name:PERSONAL HOMECARE INC
Other - Org Name:1ST CARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURKHOLDER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:434-572-1582
Mailing Address - Street 1:2808 OLD FOREST ROAD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501
Mailing Address - Country:US
Mailing Address - Phone:434-384-2412
Mailing Address - Fax:434-384-2759
Practice Address - Street 1:2808 OLD FOREST ROAD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:434-384-2412
Practice Address - Fax:434-384-2759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251E00000X, 251J00000X, 253Z00000X, 333300000X, 385HR2055X, 385HR2060X, 385HR2065X
VA332B00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333300000XSuppliersEmergency Response System Companies
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009106251Medicaid
VA008751498Medicaid