Provider Demographics
NPI:1619543626
Name:SHELTERING ARMS RESIDENTIAL LLC
Entity type:Organization
Organization Name:SHELTERING ARMS RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:SADE
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-375-1483
Mailing Address - Street 1:4665 HAYGOOD RD STE 405B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5443
Mailing Address - Country:US
Mailing Address - Phone:757-375-1483
Mailing Address - Fax:757-407-0429
Practice Address - Street 1:4665 HAYGOOD RD STE 405B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5443
Practice Address - Country:US
Practice Address - Phone:757-375-1483
Practice Address - Fax:757-407-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty