Provider Demographics
NPI:1003849209
Name:AMELIA, LLC
Entity Type:Organization
Organization Name:AMELIA, LLC
Other - Org Name:AMELIA NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-561-5611
Mailing Address - Street 1:8830 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002-4826
Mailing Address - Country:US
Mailing Address - Phone:804-561-5611
Mailing Address - Fax:804-561-5533
Practice Address - Street 1:8830 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:AMELIA COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23002-4826
Practice Address - Country:US
Practice Address - Phone:804-561-5611
Practice Address - Fax:804-561-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2476314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA175387OtherANTHEM
VA004953584Medicaid
VA004953584Medicaid