Provider Demographics
NPI:1932216546
Name:HEALTH CENTER COMMISSION OF ORANGE COUNTY
Entity Type:Organization
Organization Name:HEALTH CENTER COMMISSION OF ORANGE COUNTY
Other - Org Name:ORANGE COUNTY NURSING HOME & HOME FOR ADULTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-672-2611
Mailing Address - Street 1:120 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-1058
Mailing Address - Country:US
Mailing Address - Phone:540-672-2611
Mailing Address - Fax:540-672-3187
Practice Address - Street 1:120 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-1058
Practice Address - Country:US
Practice Address - Phone:540-672-2611
Practice Address - Fax:540-672-3187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVLO04038310400000X
VANH2647314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004965736Medicaid
VA004953592Medicaid