Provider Demographics
NPI:1477865996
Name:CALATHEA HOME HEALTH
Entity Type:Organization
Organization Name:CALATHEA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:
Authorized Official - First Name:RUTHETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FANNIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-448-5009
Mailing Address - Street 1:17484 CENTER DR
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-2884
Mailing Address - Country:US
Mailing Address - Phone:804-448-5009
Mailing Address - Fax:804-448-5353
Practice Address - Street 1:17484 CENTER DR
Practice Address - Street 2:SUITE 2C
Practice Address - City:RUTHER GLEN
Practice Address - State:VA
Practice Address - Zip Code:22546-2884
Practice Address - Country:US
Practice Address - Phone:804-448-5009
Practice Address - Fax:804-448-5353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10320305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service