Healthcare Provider Details

I. General information

NPI: 1336149871
Provider Name (Legal Business Name): OAK SPRINGS NURSING HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 HASTINGS LN
WARRENTON VA
20186-2110
US

IV. Provider business mailing address

614 HASTINGS LN
WARRENTON VA
20186-2110
US

V. Phone/Fax

Practice location:
  • Phone: 540-347-4770
  • Fax: 540-347-5101
Mailing address:
  • Phone: 540-347-4770
  • Fax: 540-347-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH2645
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2645
License Number StateVA

VIII. Authorized Official

Name: MISS BETHANY VINER
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATIVE CNHA
Phone: 540-347-4770