Provider Demographics
NPI:1043356454
Name:WESTMINSTER-CANTERBURY OF HAMPTON ROADS, INC.
Entity Type:Organization
Organization Name:WESTMINSTER-CANTERBURY OF HAMPTON ROADS, INC.
Other - Org Name:THE BALLENTINE HOME CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:J.
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:UNKLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:757-496-1100
Mailing Address - Street 1:3100 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1199
Mailing Address - Country:US
Mailing Address - Phone:757-496-1100
Mailing Address - Fax:
Practice Address - Street 1:7211 GRANBY ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4001
Practice Address - Country:US
Practice Address - Phone:757-440-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAELO2006315310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA496698Medicare Oscar/Certification