Provider Demographics
NPI:1932580446
Name:CARE BY PROFESSIONALS, INC
Entity Type:Organization
Organization Name:CARE BY PROFESSIONALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-358-2411
Mailing Address - Street 1:1301 ROSENEATH RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4623
Mailing Address - Country:US
Mailing Address - Phone:804-358-2411
Mailing Address - Fax:804-358-0141
Practice Address - Street 1:1301 ROSENEATH RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4623
Practice Address - Country:US
Practice Address - Phone:804-358-2411
Practice Address - Fax:804-358-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4974336Medicaid
VA0156444355Medicaid
VA1558445502Medicare UPIN
VA4974336Medicaid