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General NPI Number Information
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NPI Number | 1588246557
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Entity Type | Organization
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Legal Business Name | HENRICO VA OPCO LLC
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 1503 MICHAELS RD
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City | HENRICO
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State | VA
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Zip | 23229-4822
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Country | US
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Telephone | 804-288-6245
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Fax |
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Provider Business Mailing Address
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Address Line | 3512 QUENTIN RD STE 202
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City | BROOKLYN
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State | NY
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Zip | 11234-4245
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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 | COO
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Name | BATYA GORELICK
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Credential |
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Telephone | 804-288-6245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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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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