1538920913 NPI number — HEALING HANDS AT HOME CARE

Table of content: MS. SANDRA L. ADDISON L.C.S.W. (NPI 1114935202)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538920913 NPI number — HEALING HANDS AT HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING HANDS AT HOME CARE
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:
Provider Other Organization Name Type Code:
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:
1538920913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1617 ANGUS RD NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROANOKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24017-2105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-904-3822
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
182 OAKDALE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOONES MILL
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24065-4840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-904-3822
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCADDEN
Authorized Official First Name:
QUIANNA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
540-904-3822

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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