Provider Demographics
NPI:1679973424
Name:COMMONWEALTH HOME HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:COMMONWEALTH HOME HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-633-2180
Mailing Address - Street 1:321 OFFICE SQUARE LN
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3655
Mailing Address - Country:US
Mailing Address - Phone:757-633-2180
Mailing Address - Fax:
Practice Address - Street 1:321 OFFICE SQUARE LN
Practice Address - Street 2:SUITE 101A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3655
Practice Address - Country:US
Practice Address - Phone:757-633-2180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHC0-151188251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health