Provider Demographics
NPI:1477092989
Name:HOME CARE SOLUTIONS, MID ATLANTIC LLC
Entity Type:Organization
Organization Name:HOME CARE SOLUTIONS, MID ATLANTIC LLC
Other - Org Name:HOME CARE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN ( DEE)
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-392-7336
Mailing Address - Street 1:816 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-1608
Mailing Address - Country:US
Mailing Address - Phone:434-392-7336
Mailing Address - Fax:
Practice Address - Street 1:6225 BRANDON AVE STE 350
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2519
Practice Address - Country:US
Practice Address - Phone:434-808-4205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME RECOVERY-HOME AID, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation