Healthcare Provider Details

I. General information

NPI: 1942876982
Provider Name (Legal Business Name): NEWPORT NEWS VA OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 RIDGEWOOD PKWY
NEWPORT NEWS VA
23602-4415
US

IV. Provider business mailing address

980 SYLVAN AVE
ENGLEWOOD CLIFFS NJ
07632-3301
US

V. Phone/Fax

Practice location:
  • Phone: 757-703-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BATYA GORECLICK
Title or Position: COO
Credential:
Phone: 757-703-4200