# SHORE LIFECARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Shore Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669422853
- **Authorized official:** WALTER WILLIAM AUSTIN JR. (SR VP/CFO/TREASURER)
- **Authorized official phone:** (757) 531-7015

## Contact information

- **Practice address:** 26181 PARKSLEY RD, PARKSLEY, VA 23421-3723
- **Practice address phone:** (757) 665-5133
- **Practice address fax:** (757) 665-5136
- **Mailing address:** 608 DENBIGH BLVD STE 600, NEWPORT NEWS, VA 23608-4411
- **Mailing address phone:** (757) 875-2023
- **Mailing address fax:** (757) 875-2016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH2475 | VA | Yes |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 01/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004953347 | — | VA |
| 01 | — | 1273950001 | DURABLE MED EQUIPMENT | VA |