Healthcare Provider Details

I. General information

NPI: 1003863648
Provider Name (Legal Business Name): SHENANDOAH VALLEY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MONTVUE DR
LURAY VA
22835-1057
US

IV. Provider business mailing address

30 MONTVUE DR P.O. BOX 48
LURAY VA
22835-1057
US

V. Phone/Fax

Practice location:
  • Phone: 540-743-4571
  • Fax: 540-743-1986
Mailing address:
  • Phone: 540-743-4571
  • Fax: 540-743-1986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number495255
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number4952553
License Number StateVA

VIII. Authorized Official

Name: MR. BRIAN B PHELPS
Title or Position: S/T/OWNER/CFO
Credential:
Phone: 540-843-3280