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Tiffany Wallace, QMHP
Home Health Agency in Virginia Beach, Virginia
NPI 1205582509

Tiffany Wallace is a Home Health Agency based in Virginia Beach, VA. Tiffany Wallace practices in Virginia Beach, VA and has the professional credentials of QMHP. The NPI Number for Tiffany Wallace is 1205582509 and holds a License No. (Virginia).

The current practice location address for Tiffany Wallace is 5881 Ludington Dr, Virginia Beach, VA and can be reached out via phone at 757-288-1363.

Location: 5881 Ludington Dr, Virginia Beach, VA, 23464-1546
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205582509
Provider Name
Tiffany Wallace
Credential
QMHP
Provider Entity Type
Individual
Gender
Female
Address
5881 Ludington Dr, Virginia Beach, VA, 23464-1546
Phone Number
757-288-1363
Fax Number
Provider Enumeration Date
02/24/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6728 05 VA
institution
Provider Business Practice Location Address Details
Address
5881 Ludington Dr
City
Virginia Beach
State
Virginia
Zip
23464-1546
Phone Number
757-288-1363
Fax Number
person
Provider Business Mailing Address Details
Address
5881 Ludington Dr
City
Virginia Beach
State
Virginia
Zip
23464-1546
Phone Number
757-288-1363
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
()
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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