Provider Demographics
NPI:1760199640
Name:CHARTER SENIOR LIVING POQUOSON, LLC
Entity Type:Organization
Organization Name:CHARTER SENIOR LIVING POQUOSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-868-0335
Mailing Address - Street 1:531 WYTHE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1562
Mailing Address - Country:US
Mailing Address - Phone:757-236-7334
Mailing Address - Fax:
Practice Address - Street 1:531 WYTHE CREEK RD
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1562
Practice Address - Country:US
Practice Address - Phone:757-236-7334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility