Provider Demographics
NPI:1164674206
Name:NRV NURSING CENTER INCORPORATED
Entity Type:Organization
Organization Name:NRV NURSING CENTER INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:540-443-3447
Mailing Address - Street 1:1000 LITTON LN
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6399
Mailing Address - Country:US
Mailing Address - Phone:540-443-3448
Mailing Address - Fax:540-961-0411
Practice Address - Street 1:1000 LITTON LN
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6399
Practice Address - Country:US
Practice Address - Phone:540-443-3447
Practice Address - Fax:540-961-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4960785313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA49A026Medicaid