Provider Demographics
NPI:1811035645
Name:PERSONAL HOMECARE INC
Entity Type:Organization
Organization Name:PERSONAL HOMECARE INC
Other - Org Name:1ST CARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURKHOLDER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:434-572-1582
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:425 MAIN STREET
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-1006
Mailing Address - Country:US
Mailing Address - Phone:434-572-1582
Mailing Address - Fax:434-572-2631
Practice Address - Street 1:425 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-1006
Practice Address - Country:US
Practice Address - Phone:434-572-1582
Practice Address - Fax:434-572-2631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child