Provider Demographics
NPI:1366844268
Name:CPLACE RURAL RETREAT SNF, LLC
Entity Type:Organization
Organization Name:CPLACE RURAL RETREAT SNF, LLC
Other - Org Name:CARRINGTON PLACE OF RURAL RETREAT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:HEBBELN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-797-5200
Mailing Address - Street 1:514 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RURAL RETREAT
Mailing Address - State:VA
Mailing Address - Zip Code:24368-3123
Mailing Address - Country:US
Mailing Address - Phone:276-613-4700
Mailing Address - Fax:
Practice Address - Street 1:514 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:RURAL RETREAT
Practice Address - State:VA
Practice Address - Zip Code:24368-3123
Practice Address - Country:US
Practice Address - Phone:276-613-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility