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General NPI Number Information
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NPI Number | 1881738342
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Entity Type | Organization
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Legal Business Name | BABCOCK MANOR, INC,
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4151 PUMPING STATION RD
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City | APPOMATTOX
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State | VA
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Zip | 24522-3564
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Country | US
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Telephone | 434-352-8686
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Fax |
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Provider Business Mailing Address
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Address Line | 4151 PUMPING STATION RD
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City | APPOMATTOX
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State | VA
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Zip | 24522-3564
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Country | US
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Telephone | 434-352-8686
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Fax |
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | MRS. BECKY BABCOCK ROSSER
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Credential | R.N.
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Telephone | 434-352-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | RO-06-210
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License Number State | VA
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