Provider Demographics
NPI:1952781338
Name:SIMPLY CARE, LLC
Entity Type:Organization
Organization Name:SIMPLY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-282-4217
Mailing Address - Street 1:1377 SWIFT RUN RD
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-2336
Mailing Address - Country:US
Mailing Address - Phone:434-282-4217
Mailing Address - Fax:434-262-4004
Practice Address - Street 1:15 FORD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:STANARDSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22973-2444
Practice Address - Country:US
Practice Address - Phone:434-282-4217
Practice Address - Fax:434-262-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1386040855Medicaid