Blake Home Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLAKE HOME HEALTHCARE, LLC

Practice address

5709 S Laburnum Ave
Richmond, VA 23231-4420

Phone

(804) 545-1974

NPI assigned

Jun 17, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Montel Mayo

Title

Director/President

Phone

(804) 545-1974

Specialties & licenses 1

Addresses

Other names 1

• Blake Home Healthcare, LLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1356967145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 CARTER RD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033811",
            "telephone_number": "757-637-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 S LABURNUM AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232314420",
            "telephone_number": "804-545-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MONTEL",
        "authorized_official_title_or_position": "DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "804-545-1974"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blake Home Healthcare, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael T. Blair, PT, DPT, CMTPT
• Susan Blair, PT
• Blairs Drug Store
• Blake Home Health Agency
• Blake Home Health Agency
• Dana Crosby Blake, NURSE PRACTITIONER
• Elizabeth Blake, LCSW
• Gregory David Blake, LPC
• Laquita Blake
• Timothy E. Blake, PT, DPT, CSCS

• All providers in Richmond, VA
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.