Provider Demographics
NPI:1790657856
Name:DEMERARA ACCESS ENTERPRISE LLC
Entity type:Organization
Organization Name:DEMERARA ACCESS ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-986-8143
Mailing Address - Street 1:10004 BLUE STAR HWY
Mailing Address - Street 2:
Mailing Address - City:STONY CREEK
Mailing Address - State:VA
Mailing Address - Zip Code:23882-3218
Mailing Address - Country:US
Mailing Address - Phone:804-986-8143
Mailing Address - Fax:866-230-2666
Practice Address - Street 1:275 HAVENS RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-4519
Practice Address - Country:US
Practice Address - Phone:804-986-8143
Practice Address - Fax:866-230-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home