Heritage Hall - Clintwood

LBN: Clintwood Life Care, Llc
Heritage Hall - Clintwood is an health care organization with primary practice located at 1225 Clintwood Main St , Clintwood VA 24228. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Clintwood Life Care, Llc can be contacted via phone (276) 926-4693, or through Haines, James L via phone (540) 774-4263.

Contact Information

Primary practice address
1225 Clintwood Main St Clintwood VA 24228
Fax: (276) 926-9128
Website:
Authorized official contact:
Name: Haines, James L JD

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X NH2573 Virginia

Profile Details

NPI number 1447241351
LBN Legal business name Clintwood Life Care, Llc
DBA Doing business as Heritage Hall - Clintwood
Authorized official Haines, James L JD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 31st, 2005
Last updated Jul 6th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447241351 NPPES
Virginia Other 177351 ANTHEM BCBS PROVIDER ID
Virginia Other 200515606 ANTHEM BCBS PROVIDER ID
Virginia MEDICAID 4953207 ANTHEM BCBS PROVIDER ID

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