# MARY IMMACULATE NURSING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Saint Francis Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225075294
- **Authorized official:** KIMBERLY RALSTON (SYSTEM DIRECTOR)
- **Authorized official phone:** (419) 996-5119

## Contact information

- **Practice address:** 4 RIDGEWOOD PKWY, NEWPORT NEWS, VA 23602-4415
- **Practice address phone:** (757) 886-6500
- **Practice address fax:** (757) 886-6539
- **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 |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2695 | VA | Yes |

## Other

- **Enumeration date:** 05/31/2006
- **Last updated:** 10/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004952049 | — | VA |
| 01 | — | 227691 | ANTHEM PROVIDER NUMBER | VA |
| 05 | — | 4952049 | — | VA |