Healthcare Provider Details

I. General information

NPI: 1033180534
Provider Name (Legal Business Name): HIGHLAND RIDGE REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5872 HANKS AVE
DUBLIN VA
24084-2833
US

IV. Provider business mailing address

5872 HANKS AVE
DUBLIN VA
24084-2833
US

V. Phone/Fax

Practice location:
  • Phone: 540-674-4193
  • Fax: 540-674-6734
Mailing address:
  • Phone: 540-674-4193
  • Fax: 540-674-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH2588
License Number StateVA

VIII. Authorized Official

Name: MS. KAREN NEWMAN WOOD
Title or Position: OFFICE MANAGER
Credential:
Phone: 276-694-7161