Healthcare Provider Details

I. General information

NPI: 1558394650
Provider Name (Legal Business Name): HP/CARRINGTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 ATHERHOLT RD
LYNCHBURG VA
24501-2148
US

IV. Provider business mailing address

2406 ATHERHOLT RD
LYNCHBURG VA
24501-2148
US

V. Phone/Fax

Practice location:
  • Phone: 434-846-3200
  • Fax: 434-846-3436
Mailing address:
  • Phone: 434-846-3200
  • Fax: 434-846-3436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2529
License Number StateVA

VIII. Authorized Official

Name: DOUGLAS K MITTLEIDER
Title or Position: PRESIDENT
Credential:
Phone: 770-619-0866