Name | Value |
---|---|
PROVIDER TYPE | Other Service |
CLASSIFICATION | Home Health Aide |
STATUS | Inactive |
DATE INACTIVATED | 1998-10-20 00:00:00 |
VA CODE | V080400 |
reserved | P670 |
INDIVIDUAL/NON | INDIVIDUAL |
MASTER ENTRY FOR VUID | YES |
VUID | 5253113 |
EFFECTIVE DATE/TIME |
|