Provider Demographics
NPI:1639748700
Name:ENHANCING LIVES HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ENHANCING LIVES HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMICO
Authorized Official - Middle Name:JARNINE
Authorized Official - Last Name:PRIESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:757-746-9445
Mailing Address - Street 1:2310 TOWER PLACE SUITE 107
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666
Mailing Address - Country:US
Mailing Address - Phone:757-746-9419
Mailing Address - Fax:
Practice Address - Street 1:2310 TOWER PLACE SUITE 107
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666
Practice Address - Country:US
Practice Address - Phone:757-746-9419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health