Provider Demographics
NPI:1982131538
Name:AMOR HOME HOME AGENCY LLC
Entity Type:Organization
Organization Name:AMOR HOME HOME AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-321-0463
Mailing Address - Street 1:5215 COLLEY AVE STE 136
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2172
Mailing Address - Country:US
Mailing Address - Phone:757-321-0463
Mailing Address - Fax:757-500-4576
Practice Address - Street 1:5215 COLLEY AVE STE 136
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2172
Practice Address - Country:US
Practice Address - Phone:757-321-0463
Practice Address - Fax:757-500-4576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1922549310Medicaid