NPI | 1417956673 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENDA L ROSENBAUGH Medical Billing Supervisor 757-716-2065 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA NH2678) |
Additional Taxonomies | 310400000X Assisted Living Facility (Licence: VA ERO 03-176) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2017-10-24 |