Provider Demographics
NPI:1790302354
Name:NEW START HOME CARE AGENCY
Entity Type:Organization
Organization Name:NEW START HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:WAKEELAH
Authorized Official - Middle Name:ANEESHA
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-937-6035
Mailing Address - Street 1:5750 CHESAPEAKE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-5325
Mailing Address - Country:US
Mailing Address - Phone:757-937-6035
Mailing Address - Fax:757-271-9301
Practice Address - Street 1:5750 CHESAPEAKE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-5325
Practice Address - Country:US
Practice Address - Phone:757-937-6035
Practice Address - Fax:757-383-6817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health