Healthcare Provider Details

I. General information

NPI: 1316199466
Provider Name (Legal Business Name): NRV NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LITTON LN
BLACKSBURG VA
24060-6399
US

IV. Provider business mailing address

1000 LITTON LN
BLACKSBURG VA
24060-6399
US

V. Phone/Fax

Practice location:
  • Phone: 540-443-3447
  • Fax: 540-961-0411
Mailing address:
  • Phone: 540-443-3447
  • Fax: 540-961-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number4960785
License Number StateVA

VIII. Authorized Official

Name: MS. KRISTI BLAKE
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 540-443-3447