Provider Demographics
NPI:1629789557
Name:D&J PROFICIENT SKILLED HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:D&J PROFICIENT SKILLED HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-275-3691
Mailing Address - Street 1:1500 CITY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-2227
Mailing Address - Country:US
Mailing Address - Phone:757-275-3691
Mailing Address - Fax:
Practice Address - Street 1:1500 CITY PARK AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-2227
Practice Address - Country:US
Practice Address - Phone:757-275-3691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care