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General NPI Number Information
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NPI Number | 1467260752
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Entity Type | Organization
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Legal Business Name | 906 THOMPSON STREET OPCO LLC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 906 THOMPSON ST
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City | ASHLAND
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State | VA
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Zip | 23005-1128
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Country | US
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Telephone | 804-798-3291
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Fax |
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Provider Business Mailing Address
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Address Line | 906 THOMPSON ST
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City | ASHLAND
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State | VA
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Zip | 23005-1128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TIFFANY HOBACK
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Credential |
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Telephone | 770-698-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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