Provider Demographics
NPI:1558758151
Name:STARLINGVIEW MANOR ASSISTED LIVING,LLC
Entity Type:Organization
Organization Name:STARLINGVIEW MANOR ASSISTED LIVING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED
Authorized Official - Phone:276-340-5962
Mailing Address - Street 1:301 STARLING AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3729
Mailing Address - Country:US
Mailing Address - Phone:276-340-5962
Mailing Address - Fax:
Practice Address - Street 1:301 STARLING AVE
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3729
Practice Address - Country:US
Practice Address - Phone:276-340-5962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility