Healthcare Provider Details
I. General information
NPI: 1962061143
Provider Name (Legal Business Name): ACCORDIUS HEALTH AT NANSEMOND POINTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2019
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 W CONSTANCE RD
SUFFOLK VA
23434-4413
US
IV. Provider business mailing address
440 SYLVAN AVE STE 240
ENGLEWOOD CLIFFS NJ
07632-2700
US
V. Phone/Fax
- Phone: 757-539-8744
- Fax:
- Phone: 757-539-8744
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BATYA
GORELICK
Title or Position: VP OF ADMIN SERVICES
Credential:
Phone: 757-539-8744