Provider Demographics
NPI:1821310624
Name:HANOVER HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:HANOVER HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:W
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:804-746-9019
Mailing Address - Street 1:9291 LAUREL GROVE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2947
Mailing Address - Country:US
Mailing Address - Phone:804-569-6340
Mailing Address - Fax:804-569-6342
Practice Address - Street 1:9291 LAUREL GROVE RD STE 104
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2947
Practice Address - Country:US
Practice Address - Phone:804-569-6340
Practice Address - Fax:804-569-6342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO10609251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health