Provider Demographics
NPI:1003705633
Name:PONDEROSA HOME HEALTH CARE INC.
Entity type:Organization
Organization Name:PONDEROSA HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINIKA
Authorized Official - Middle Name:ANDAWANDA
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-472-7525
Mailing Address - Street 1:3449 SANDY POINT RD
Mailing Address - Street 2:
Mailing Address - City:KINSALE
Mailing Address - State:VA
Mailing Address - Zip Code:22488-2535
Mailing Address - Country:US
Mailing Address - Phone:804-472-7525
Mailing Address - Fax:
Practice Address - Street 1:3449 SANDY POINT RD
Practice Address - Street 2:
Practice Address - City:KINSALE
Practice Address - State:VA
Practice Address - Zip Code:22488-2535
Practice Address - Country:US
Practice Address - Phone:804-472-7525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty