Healthcare Provider Details

I. General information

NPI: 1306836655
Provider Name (Legal Business Name): ALBEMARLE LIFECARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 RIO RD W
CHARLOTTESVILLE VA
22901-1411
US

IV. Provider business mailing address

505 RIO RD W
CHARLOTTESVILLE VA
22901-1411
US

V. Phone/Fax

Practice location:
  • Phone: 434-978-7015
  • Fax: 434-974-7882
Mailing address:
  • Phone: 434-978-7015
  • Fax: 434-974-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2572
License Number StateVA

VIII. Authorized Official

Name: MR. TED A LENEAVE
Title or Position: PRESIDENT/COO
Credential:
Phone: 540-774-4263