Provider Demographics
NPI:1073500880
Name:VIRGINIA HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:VIRGINIA HEALTH SERVICES, INC
Other - Org Name:LANCASHIRE CONVALESCENT AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOLDY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:757-599-7422
Mailing Address - Street 1:240 NAT TURNER BLVD S
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-0020
Mailing Address - Country:US
Mailing Address - Phone:757-596-6268
Mailing Address - Fax:757-595-0966
Practice Address - Street 1:287 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-3830
Practice Address - Country:US
Practice Address - Phone:804-435-1684
Practice Address - Fax:804-435-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2605314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004953452Medicaid
VA245113OtherANTHEM
VA495345Medicare UPIN