Provider Demographics
NPI:1558119347
Name:SMP COMPANIONSHIP AND CARE, LLC
Entity type:Organization
Organization Name:SMP COMPANIONSHIP AND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LA-TOYA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-986-7759
Mailing Address - Street 1:1680 OLD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2448
Mailing Address - Country:US
Mailing Address - Phone:703-986-7759
Mailing Address - Fax:
Practice Address - Street 1:1680 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2448
Practice Address - Country:US
Practice Address - Phone:703-986-7759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health