Provider Demographics
NPI:1134994890
Name:ANNIE'S DIVINE TOUCH HOME CARE LLC
Entity type:Organization
Organization Name:ANNIE'S DIVINE TOUCH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-454-5610
Mailing Address - Street 1:6405 WOODED GLEN CT APT 201
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7790
Mailing Address - Country:US
Mailing Address - Phone:804-454-5610
Mailing Address - Fax:
Practice Address - Street 1:2807 N PARHAM RD RM 370
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4410
Practice Address - Country:US
Practice Address - Phone:804-454-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care