Healthcare Provider Details

I. General information

NPI: 1750955936
Provider Name (Legal Business Name): SPRINGTREE OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 SPRINGTREE DR NE
ROANOKE VA
24012-6443
US

IV. Provider business mailing address

3433 SPRINGTREE DR NE
ROANOKE VA
24012-6443
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-2790
  • 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

VIII. Authorized Official

Name: ADAM EDWARDS
Title or Position: ADMINISTRATOR
Credential:
Phone: 540-981-2790