Healthcare Provider Details

I. General information

NPI: 1427054410
Provider Name (Legal Business Name): WILLIAMSBURG LANDING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 WILLIAMSBURG LANDING DR
WILLIAMSBURG VA
23185-8064
US

IV. Provider business mailing address

5700 WILLIAMSBURG LANDING DR
WILLIAMSBURG VA
23185-3779
US

V. Phone/Fax

Practice location:
  • Phone: 757-253-0303
  • Fax: 757-565-6537
Mailing address:
  • Phone: 757-253-0303
  • Fax: 757-565-6537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyX
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2729
License Number StateVA
# 2
Primary TaxonomyX
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberPLO040016
License Number StateVA

VIII. Authorized Official

Name: NANCY HARRISON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 757-253-0303