Provider Demographics
NPI:1659671857
Name:YVONNE FLOOD-COOK
Entity Type:Organization
Organization Name:YVONNE FLOOD-COOK
Other - Org Name:COOK COMMUNITY SUPPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOOD-COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-653-4811
Mailing Address - Street 1:3707 BRIDLE PATH LN
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3201
Mailing Address - Country:US
Mailing Address - Phone:757-653-4811
Mailing Address - Fax:757-394-1259
Practice Address - Street 1:3707 BRIDLE PATH LN
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3201
Practice Address - Country:US
Practice Address - Phone:757-653-4811
Practice Address - Fax:757-394-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA110103011253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care