# BON SECOURS MARYVIEW NURSING CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124033980
- **Authorized official:** KIMBERLY RALSTON (SYSTEM DIRECTOR)
- **Authorized official phone:** (419) 996-5119

## Contact information

- **Practice address:** 4775 BRIDGE RD, SUFFOLK, VA 23435-2045
- **Practice address phone:** (757) 686-0488
- **Practice address fax:** (757) 686-8211
- **Mailing address:** 8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
- **Mailing address phone:** (804) 627-5573
- **Mailing address fax:** (866) 449-0896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH2511 | VA | — |
| 314000000X | Skilled Nursing Facility | NH2511 | VA | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 10/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4952065 | — | VA |