Provider Demographics
NPI:1932535705
Name:HOUSEHOLD EMPLOYER HOME CARE
Entity type:Organization
Organization Name:HOUSEHOLD EMPLOYER HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER OF RECORD
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:OHARA
Authorized Official - Last Name:SHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-722-1126
Mailing Address - Street 1:1106 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4602
Mailing Address - Country:US
Mailing Address - Phone:757-722-1126
Mailing Address - Fax:757-722-1126
Practice Address - Street 1:1106 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4602
Practice Address - Country:US
Practice Address - Phone:757-722-1126
Practice Address - Fax:757-722-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA650136414016Medicaid