Provider Demographics
NPI:1073732657
Name:VIRGINIA UNITED METHODIST HOMES, INC.
Entity Type:Organization
Organization Name:VIRGINIA UNITED METHODIST HOMES, INC.
Other - Org Name:HERMITAGE ROANOKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SALMINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-474-8707
Mailing Address - Street 1:120 EASTSHORE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5985
Mailing Address - Country:US
Mailing Address - Phone:804-474-8707
Mailing Address - Fax:
Practice Address - Street 1:1009 OLD COUNTRY CLUB RD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-2927
Practice Address - Country:US
Practice Address - Phone:540-767-6810
Practice Address - Fax:540-344-8919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA UNITED METHODIST HOMES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
VANH2674313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1073732657Medicare PIN