Provider Demographics
NPI:1619345691
Name:MALVIA'S CRAFT & SERVICES, INC.
Entity Type:Organization
Organization Name:MALVIA'S CRAFT & SERVICES, INC.
Other - Org Name:MALVIA'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR & PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MALVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-247-6139
Mailing Address - Street 1:180 SUNSHINE DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6746
Mailing Address - Country:US
Mailing Address - Phone:540-247-6139
Mailing Address - Fax:540-696-2584
Practice Address - Street 1:180 SUNSHINE DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-6746
Practice Address - Country:US
Practice Address - Phone:540-247-6139
Practice Address - Fax:540-696-2584
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MALVIA'S CRAFT & SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA253Z00000X
VA000000000253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care