Provider Demographics
NPI:1366620486
Name:CARE ALTERNATIVES OF VIRGINIA LLC
Entity type:Organization
Organization Name:CARE ALTERNATIVES OF VIRGINIA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YEWANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:EFODILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-931-9080
Mailing Address - Street 1:70 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3510
Mailing Address - Country:US
Mailing Address - Phone:908-931-9068
Mailing Address - Fax:908-931-9698
Practice Address - Street 1:10571 TELEGRAPH RD
Practice Address - Street 2:SUITE 203
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-4652
Practice Address - Country:US
Practice Address - Phone:804-673-1330
Practice Address - Fax:804-673-2778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHSP-09151251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1366620486Medicaid
VA1366620486Medicaid