Provider Demographics
NPI:1700138708
Name:STANLEYS PERSONAL TOUCH HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:STANLEYS PERSONAL TOUCH HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-925-1180
Mailing Address - Street 1:908 WEST WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6252
Mailing Address - Country:US
Mailing Address - Phone:757-925-1180
Mailing Address - Fax:757-925-1190
Practice Address - Street 1:908 WEST WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6252
Practice Address - Country:US
Practice Address - Phone:757-925-1180
Practice Address - Fax:757-925-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-13772251E00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care