Provider Demographics
NPI:1629406905
Name:NEHEMIAH ASSISTED LIVING FACILITY
Entity Type:Organization
Organization Name:NEHEMIAH ASSISTED LIVING FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINNISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-224-1928
Mailing Address - Street 1:105 WATKINS DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-3654
Mailing Address - Country:US
Mailing Address - Phone:757-224-1928
Mailing Address - Fax:757-257-6388
Practice Address - Street 1:105 WATKINS DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-3654
Practice Address - Country:US
Practice Address - Phone:757-224-1928
Practice Address - Fax:757-257-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALF1104365310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility