# BLACKSBURG LIFE CARE, LLC

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

## Provider details

- **NPI number:** 1265422646
- **Authorized official:** CASSANDRA GALLANT (COMPLIANCE & PRIVACY OFFICER)
- **Authorized official phone:** (540) 774-4263

## Contact information

- **Practice address:** 3610 S MAIN ST, BLACKSBURG, VA 24060
- **Practice address phone:** (540) 951-7000
- **Practice address fax:** (540) 951-4109
- **Mailing address:** 3131 ELECTRIC RD, ROANOKE, VA 24018-6427
- **Mailing address phone:** (540) 774-4263
- **Mailing address fax:** (540) 774-0780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2569 | VA | Yes |

## Other

- **Enumeration date:** 10/26/2005
- **Last updated:** 05/08/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 180503 | ANTHEM BCBS PROVIDER ID | VA |
| 01 | — | 200515600 | FEDERAL BLACK LUNG | VA |
| 05 | — | 4953568 | — | VA |