Provider Demographics
NPI:1013424472
Name:INTERNAL LIFE HOMECARE LLC
Entity type:Organization
Organization Name:INTERNAL LIFE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CIARA
Authorized Official - Middle Name:CASHAY
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-977-2218
Mailing Address - Street 1:5660 E VIRGINIA BEACH BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2468
Mailing Address - Country:US
Mailing Address - Phone:757-470-5798
Mailing Address - Fax:757-275-7580
Practice Address - Street 1:5660 E VIRGINIA BEACH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2468
Practice Address - Country:US
Practice Address - Phone:757-470-5798
Practice Address - Fax:757-275-7580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health