Healthcare Provider Details

I. General information

NPI: 1972467884
Provider Name (Legal Business Name): RAH WINTHROP MANOR ASSISTED LIVING FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 IDLEWOOD AVE
RICHMOND VA
23220-5856
US

IV. Provider business mailing address

2100 IDLEWOOD AVE
RICHMOND VA
23220-5856
US

V. Phone/Fax

Practice location:
  • Phone: 804-278-8982
  • Fax:
Mailing address:
  • Phone: 804-278-8982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CELESTINE DABIS HICKS
Title or Position: 100 PERCENT OWNER
Credential:
Phone: 804-731-6129