Provider Demographics
NPI:1467541763
Name:FAUQUIER HEALTH SENIOR LIVING INC
Entity Type:Organization
Organization Name:FAUQUIER HEALTH SENIOR LIVING INC
Other - Org Name:FAUQUIER HEALTH REHABILITATION & NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-316-5500
Mailing Address - Street 1:360 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3006
Mailing Address - Country:US
Mailing Address - Phone:540-316-5500
Mailing Address - Fax:540-316-5389
Practice Address - Street 1:360 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3006
Practice Address - Country:US
Practice Address - Phone:540-316-5500
Practice Address - Fax:540-316-5389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2716314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004952332Medicaid
260003OtherALLIANCE PROVIDER NO
215430OtherBC NON-PROVIDER NO
215430OtherBC NON-PROVIDER NO
VA495233Medicare Oscar/Certification