Provider Demographics
NPI:1750191888
Name:COMMUNITY BASED
Entity type:Organization
Organization Name:COMMUNITY BASED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-798-3444
Mailing Address - Street 1:468 INVESTORS PL STE 204A
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1109
Mailing Address - Country:US
Mailing Address - Phone:757-798-3444
Mailing Address - Fax:757-937-1051
Practice Address - Street 1:608 THALIA RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1814
Practice Address - Country:US
Practice Address - Phone:757-798-3444
Practice Address - Fax:757-937-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health