Provider Demographics
NPI:1770025231
Name:EPIC RESOLUTION HOME CARE
Entity type:Organization
Organization Name:EPIC RESOLUTION HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATIA
Authorized Official - Middle Name:ARIEL
Authorized Official - Last Name:DURANT
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CNA/PCA
Authorized Official - Phone:804-980-9731
Mailing Address - Street 1:10124 SAINT JOAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1958
Mailing Address - Country:US
Mailing Address - Phone:804-651-0396
Mailing Address - Fax:
Practice Address - Street 1:10124 SAINT JOAN AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-1958
Practice Address - Country:US
Practice Address - Phone:804-651-0396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health