Active NPI
Senior Living Choices, of VA, Inc
- Skilled Nursing Facility
- Midlothian, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH2566
- Legal business name
- SENIOR LIVING CHOICES, OF VA, INC
- Practice address
- 2100 Brandermill Pkwy
Midlothian, VA 23112-4160 - Phone
- (804) 379-7100
- Fax
- (804) 379-3726
- NPI assigned
- Oct 18, 2005
- Last updated
- Sep 26, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Mira Dean Pallotta
- Title
- Executive Director
- Phone
- (804) 744-1173
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH2566 | VA | Primary |
Addresses
Primary practice location
2100 Brandermill Pkwy
Midlothian, VA 23112-4160
Mailing address
2100 Brandermill Pkwy
Midlothian, VA 23112
Phone (804) 744-1173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4951832 | Medicaid | VA |
Other names 1
- Senior Living Choices, Inc
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070809000049 | VA | Part A Provider - Skilled Nursing Facility | 8921199753 | Practice locations: Midlothian, VA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1770572190. Details of each certification follow.
Skilled nursing facility certification: CCN 495183
- Legal name
- SENIOR LIVING CHOICES OF VA INC
- Doing business as
- BRANDERMILL WOODS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Nov 2, 1988
- Last certification
- Mar 30, 2023
- Beds
- 60
- Ownership / control type
- Other Nonprofit
- Organization structure
- Corporation
- Incorporated
- Jan 13, 2011 in VA
- Enrollment address
- 2100 Brandermill Parkway
Midlothian, VA 23112 - Nursing home name
- THE HAVEN AT BRANDERMILL WOODS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Haven at Brandermill Woods
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Nov 2, 1988
- Medicare certification status
- Active
- Certified beds
- 60
National Provider Directory
National Provider Directory- Tax ID family
- Brandermill Woods Retirement Community
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Brandermill Woods Retirement Community
- Physical Therapist
- Midlothian, VA
- NPI 1093926594
-
dba Brandermill Woods Retirement Community
- Occupational Therapist
- Midlothian, VA
- NPI 1639380132
-
dba Brandermill Woods Retirement Community
- Speech-Language Pathologist
- Midlothian, VA
- NPI 1720299225
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Frasier Brickhouse | Corporate Director | Aug 3, 2007 | |
| Tomeka Scott | Corporate Director | Apr 6, 2011 | |
| Adp of the SNF | May 4, 2017 | ||
| Lynda Preiss | Corporate Officer | Jan 1, 2019 | 100% |
| Operational/Managerial Control | Dec 16, 2018 | ||
| Adp of the SNF | Dec 16, 2018 | ||
| Wayne Edmunds | Corporate Director | Aug 3, 2007 | |
| Ellen Llewellyn | Corporate Director | Jan 1, 2019 | 100% |
| Adp of the SNF | Dec 16, 2018 | ||
| Bradford Hammer | Corporate Director | Aug 3, 2007 |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1411689600000",
"number": "1770572190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 BRANDERMILL PKWY",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "23112",
"telephone_number": "804-744-1173",
"fax_number": "804-744-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 BRANDERMILL PKWY",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231124160",
"telephone_number": "804-379-7100",
"fax_number": "804-379-3726"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR LIVING CHOICES, OF VA, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-18",
"last_updated": "2014-09-26",
"status": "A",
"authorized_official_last_name": "PALLOTTA",
"authorized_official_first_name": "MIRA",
"authorized_official_middle_name": "DEAN",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "804-744-1173",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "VA",
"license": "NH2566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4951832",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Senior Living Choices, Inc",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Midlothian, VA
- Nilza Seixas
- Nhoc Semus
- Senior Living Choices, Inc (Brandermill Woods Retirement Community)
- Senior Living Choices, Inc (Brandermill Woods Retirement Community)
- Senior Living Choices, Inc (Brandermill Woods Retirement Community)
- Kathleen Suzette Seow, LPC
- Marie Katherine Serfis, PA-C
- Grady Sessoms Jr.
- Samuel Sessou, M.D.
- SF Medical Consulting, LLC (Housecalls-Rva)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.