Provider Demographics
NPI:1215475215
Name:MRS. MARY'S LOVING ARMS HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:MRS. MARY'S LOVING ARMS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-653-8707
Mailing Address - Street 1:38086 LANKFORD HIGHWAY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BELLE HAVEN
Mailing Address - State:VA
Mailing Address - Zip Code:23308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:38086 LANKFORD HIGHWAY
Practice Address - Street 2:SUITE 308
Practice Address - City:BELLE HAVEN
Practice Address - State:VA
Practice Address - Zip Code:23308
Practice Address - Country:US
Practice Address - Phone:757-653-8707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171588251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO- 171588OtherCOMMON WEALTH OF VIRGINIA- VIRGINIA DEPARTMENT OF HEALTH