Organization Active NPI

Senior Living Choices, of VA, Inc

  • Skilled Nursing Facility
  • Midlothian, VA
National Provider Identifier
1770572190
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2566 Issued in VA
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, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4951832MedicaidVA

Other names 1

  • Senior Living Choices, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 WoodsCCN 495183 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Nov 2, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6050.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Brandermill Woods Retirement Community4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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.

NameRoleSinceShare
Frasier Brickhouse Individual Corporate Director Aug 3, 2007
Tomeka Scott Individual Corporate DirectorAdministrator Apr 6, 2011
Adp of the SNF May 4, 2017
Lynda Preiss Individual Corporate OfficerExec Director Assist Sec of the Jan 1, 2019 100%
Operational/Managerial Control Dec 16, 2018
Adp of the SNF Dec 16, 2018
Wayne Edmunds Individual Corporate Director Aug 3, 2007
Ellen Llewellyn Individual Corporate DirectorAssoc Exec Director Jan 1, 2019 100%
Adp of the SNF Dec 16, 2018
Bradford Hammer Individual 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

Sources for this page

Verify at the official NPI Registry.