Provider Demographics
NPI:1548995913
Name:ITS ALL ABOUT CARING LLC
Entity type:Organization
Organization Name:ITS ALL ABOUT CARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROADDUS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:804-664-2271
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:SAINT STEPHENS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:23148-0013
Mailing Address - Country:US
Mailing Address - Phone:804-664-2271
Mailing Address - Fax:804-417-6073
Practice Address - Street 1:5833 RICHMOND TAPPAHANNOCK HWY STE 106B
Practice Address - Street 2:
Practice Address - City:AYLETT
Practice Address - State:VA
Practice Address - Zip Code:23009-3007
Practice Address - Country:US
Practice Address - Phone:804-223-0029
Practice Address - Fax:804-417-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0732762767Medicaid
VA1003383688Medicaid