NPI | 1104809631 |
---|---|
Entity Type | Organization |
Authorized Contact | SUE H MYATT Administrator 757-853-6281 |
Organization Subpart ? | No |
Primary Taxonomy | 310400000X Assisted Living Facility (Licence: VA ELO 2005-630) |
Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: VA NH2703) |
Enumeration Date | 2005-11-29 |
Last Update Date | 2020-08-22 |