Provider Demographics
NPI:1417461476
Name:AT HOME CARE STAFFING - WILLIAMSBURG
Entity Type:Organization
Organization Name:AT HOME CARE STAFFING - WILLIAMSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/ BOM
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-358-0631
Mailing Address - Street 1:5700 OLD RICHMOND AVE STE D18
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1828
Mailing Address - Country:US
Mailing Address - Phone:804-358-0631
Mailing Address - Fax:804-612-3716
Practice Address - Street 1:5501 DISCOVERY PARK BLVD STE 5
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2952
Practice Address - Country:US
Practice Address - Phone:804-358-0631
Practice Address - Fax:804-612-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health