Videll Healthcare Duffield LLC
Organization Active NPI Skilled Nursing Facility · Duffield, VA
NPI 1396768644 · NPPES record last updated Nov 15, 2012
Key facts
- NPI
- 1396768644
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NH2664 (VA)
- Legal business name
- VIDELL HEALTHCARE DUFFIELD LLC
- Practice address
- 157 Ross Carter Blvd
Duffield, VA 24244-5116 - Phone
- (276) 431-2841
- Fax
- (276) 431-2345
- NPI assigned
- Jul 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kathleen D Mace, RN DCS
- Title
- Exec Vice Pres
- Phone
- (253) 277-3197
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH2664 | VA | Yes |
Addresses
Primary practice location
157 Ross Carter Blvd
Duffield, VA 24244-5116
Mailing address
157 Ross Carter Blvd
Duffield, VA 24244-0280
Phone (276) 431-2841
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4951344 | Medicaid | VA | |
| 4960386 | Medicaid | VA |
Other names
- Ridgecrest Manor Nursing and Rehabilitation Center
Other providers in Duffield, VA
- Cynthia Renee Taylor
- Adrian Scott Thacker
- Tri-City Rehabilitation
- Trillium Medical Group of Virginia, Inc.
- Justin Venable
- Village Economy Drug Inc
- Elois P Wampler
- Watauga Duffield Medical Center, P.C.
- James Bryston Winegar
- Rebecca Lynn Wolford
All providers in Duffield, VA · Skilled Nursing Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.