Healthcare Provider Details

I. General information

NPI: 1013943133
Provider Name (Legal Business Name): VIRGINIA MENNONITE HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 VIRGINIA AVE
HARRISONBURG VA
22802-2433
US

IV. Provider business mailing address

1501 VIRGINIA AVE
HARRISONBURG VA
22802-2452
US

V. Phone/Fax

Practice location:
  • Phone: 540-564-3400
  • Fax: 540-564-3750
Mailing address:
  • Phone: 540-564-3400
  • Fax: 540-564-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2643
License Number StateVA

VIII. Authorized Official

Name: CURTIS STUTZMAN
Title or Position: CFO
Credential:
Phone: 540-564-3400