Provider Demographics
NPI:1912351198
Name:FREDERICKSBURG SENIOR CARE INC.
Entity Type:Organization
Organization Name:FREDERICKSBURG SENIOR CARE INC.
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-373-6906
Mailing Address - Street 1:1952 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5128
Mailing Address - Country:US
Mailing Address - Phone:540-373-6906
Mailing Address - Fax:540-899-9674
Practice Address - Street 1:1952 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5128
Practice Address - Country:US
Practice Address - Phone:540-373-6906
Practice Address - Fax:540-899-9674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-16305251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health