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Organization
DILLWYN LIFE CARE, LLC
Active
Organization
DILLWYN LIFE CARE, LLC
Active
Other names
Heritage Hall - Dillwyn
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA GALLANT (COMPLIANCE & PRIVACY OFFICER)
(540) 774-4263
Entity
Organization
Contact information
Practice address
119 BRICKYARD DR, DILLWYN, VA 23936-3362
(434) 983-2058
(434) 983-1727
Mailing address
119 BRICKYARD DR, DILLWYN, VA 23936-3362
(434) 983-2058
(434) 983-1727
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2574
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180507
ANTHEM BCBS
VA
01
—
200515609
FEDERAL BLACK LUNG
—
05
—
4953177
—
VA
Enumeration date
06/05/2018
Last updated
11/25/2024
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