Dba Indian River Retirement Community, Llc

LBN: Indian River Residential Care Community
Dba Indian River Retirement Community, Llc is an health care organization with primary practice located at 1012 Justis St , Chesapeake VA 23325-2516. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Indian River Residential Care Community can be contacted via phone (757) 523-4659, or through Pierce, Guy S via phone (336) 595-1075.

Contact Information

Primary practice address
1012 Justis St Chesapeake VA 23325-2516
Phone: (757) 523-4659
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pierce, Guy S
Phone: (336) 595-1075

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X Virginia

Profile Details

NPI number 1578639654
LBN Legal business name Indian River Residential Care Community
DBA Doing business as Dba Indian River Retirement Community, Llc
Authorized official Pierce, Guy S
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2006
Last updated Aug 22nd, 2020 - about 4 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 1578639654 NPPES
Virginia MEDICAID 5002281

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