Provider Demographics
NPI:1851628770
Name:AT HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:AT HOME HEALTHCARE LLC
Other - Org Name:HPR MEDICAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:BESSIE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-201-6200
Mailing Address - Street 1:468 S. INDEPENDENCE BLVD.
Mailing Address - Street 2:SUITE A 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1105
Mailing Address - Country:US
Mailing Address - Phone:757-201-6200
Mailing Address - Fax:757-222-1794
Practice Address - Street 1:468 S. INDEPENDENCE BLVD
Practice Address - Street 2:SUITE A 102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1105
Practice Address - Country:US
Practice Address - Phone:757-201-6200
Practice Address - Fax:757-222-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHC-10405385H00000X
VAHCO-15405385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care