Provider Demographics
NPI:1518304682
Name:ADULT HEALTHCARE SOLUTIONS, INC
Entity Type:Organization
Organization Name:ADULT HEALTHCARE SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:
Authorized Official - Last Name:COGER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:804-861-9472
Mailing Address - Street 1:402 S SYCAMORE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5043
Mailing Address - Country:US
Mailing Address - Phone:804-861-9472
Mailing Address - Fax:804-733-8884
Practice Address - Street 1:402 S SYCAMORE ST
Practice Address - Street 2:SUITE A
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-5043
Practice Address - Country:US
Practice Address - Phone:804-861-9472
Practice Address - Fax:804-733-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-13788251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0100377438Medicaid
VA0100111670Medicaid
VA0103813710Medicaid