Provider Demographics
NPI:1023894581
Name:IN-HOME SUPPORT SERVICES OF VIRGINIA LLC
Entity type:Organization
Organization Name:IN-HOME SUPPORT SERVICES OF VIRGINIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QDDP
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-339-2072
Mailing Address - Street 1:150 W WASHINGTON ST STE D
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5272
Mailing Address - Country:US
Mailing Address - Phone:757-339-2072
Mailing Address - Fax:757-539-7228
Practice Address - Street 1:150 W WASHINGTON ST STE D
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5272
Practice Address - Country:US
Practice Address - Phone:757-339-2072
Practice Address - Fax:757-539-7228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care