1639373715 NPI number — CARESOUTH HHA HOLDINGS OF RICHMOND, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639373715 NPI number — CARESOUTH HHA HOLDINGS OF RICHMOND, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARESOUTH HHA HOLDINGS OF RICHMOND, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ENHABIT HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639373715
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6688 N CENTRAL EXPRESSWAY
Provider Second Line Business Mailing Address:
SUITE 1300
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75206-3950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-239-6500
Provider Business Mailing Address Fax Number:
214-239-6581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12355 SUNRISE VALLEY DR STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RESTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20191-3492
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-992-7280
Provider Business Practice Location Address Fax Number:
703-992-6698
Provider Enumeration Date:
06/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CARLISLE
Authorized Official First Name:
CRISSY
Authorized Official Middle Name:
BUCHANAN
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
214-239-6500

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  108633 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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