# BLACKSTONE LIFE CARE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Hall - Blackstone
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215429386
- **Authorized official:** CASSANDRA GALLANT (COMPLIANCE & PRIVACY OFFICER)
- **Authorized official phone:** (540) 774-4263

## Contact information

- **Practice address:** 900 S MAIN ST, BLACKSTONE, VA 23824-2644
- **Practice address phone:** (434) 292-5301
- **Practice address fax:** (434) 292-6041
- **Mailing address:** 900 S MAIN ST, BLACKSTONE, VA 23824-2644
- **Mailing address phone:** (434) 292-5301
- **Mailing address fax:** (434) 292-6041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/04/2018
- **Last updated:** 11/25/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 180505 | ANTHEM BCBS | — |
| 01 | — | 200515603 | FEDERAL BLACK LUNG | — |
| 05 | — | 4953533 | — | VA |