Eastern State Hospital

LBN: Commonwealth Of Virginia Department Of Behavi
Eastern State Hospital is an health care organization with primary practice located at 4601 Ironbound Rd , Williamsburg VA 23188-2652. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness, which is considered as the primary health care specialty. Commonwealth Of Virginia Department Of Behavi can be contacted via phone (757) 253-5241, or through Wood, Jack L.. via phone (757) 253-5241.

Contact Information

Primary practice address
4601 Ironbound Rd Williamsburg VA 23188-2652
Phone: (757) 253-5241
Fax: (757) 253-5065
Website:
Map and Directions
Authorized official contact:
Name: Wood, Jack L.. NHA
Phone: (757) 253-5241

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness 310500000X

Profile Details

NPI number 1114027521
LBN Legal business name Commonwealth Of Virginia Department Of Behavi
DBA Doing business as Eastern State Hospital
Authorized official Wood, Jack L.. NHA
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 25th, 2006
Last updated Jun 6th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114027521 NPPES
Virginia MEDICAID 004966244

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