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General NPI Number Information
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NPI Number | 1649215252
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Entity Type | Organization
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Legal Business Name | BERRY HILL NURSING HOME, INC.
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 621 BERRY HILL RD
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-2207
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Country | US
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Telephone | 434-572-8901
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Fax | 434-572-8904
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Provider Business Mailing Address
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Address Line | PO BOX 779
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-0779
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Country | US
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Telephone | 434-572-8901
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Fax | 434-572-8904
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Authorized Official
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Title or Position | CFO
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Name | MRS. GALE BOICE
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Credential |
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Telephone | 252-523-9094
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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 | NH2502
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License Number State | VA
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