Provider Demographics
NPI:1508285743
Name:FIVE POINTS HEALTHCARE OF VIRGINIA
Entity Type:Organization
Organization Name:FIVE POINTS HEALTHCARE OF VIRGINIA
Other - Org Name:AVEANNA HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-464-8000
Mailing Address - Street 1:400 INTERSTATE NORTH PKWY SE STE 1600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5047
Mailing Address - Country:US
Mailing Address - Phone:470-464-8000
Mailing Address - Fax:770-248-8192
Practice Address - Street 1:130 CREEKSIDE LN
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-2429
Practice Address - Country:US
Practice Address - Phone:540-409-4622
Practice Address - Fax:540-313-4325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIVE POINTS HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-15
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497668Medicare Oscar/Certification