Provider Demographics
NPI:1811360431
Name:BLACKSBURG OPERATIONS LLC
Entity Type:Organization
Organization Name:BLACKSBURG OPERATIONS LLC
Other - Org Name:THE CROSSINGS AT BLACKSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DUSTIN
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LNNA
Authorized Official - Phone:540-317-3463
Mailing Address - Street 1:3400 SOUTHPOINT DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-1241
Mailing Address - Country:US
Mailing Address - Phone:540-317-3463
Mailing Address - Fax:540-315-9553
Practice Address - Street 1:3400 SOUTHPOINT DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-1241
Practice Address - Country:US
Practice Address - Phone:540-317-3463
Practice Address - Fax:540-315-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALF1104481310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility