# LAUREL MEADOWS LIFE CARE L C

> 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 Laurel Meadows
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740270297
- **Authorized official:** CASSANDRA GALLANT (COMPLIANCE & PRIVACY OFFICER)
- **Authorized official phone:** (540) 774-4263

## Contact information

- **Practice address:** 16600 DANVILLE PIKE, LAUREL FORK, VA 24352-3804
- **Practice address phone:** (276) 398-2117
- **Practice address fax:** (276) 398-3122
- **Mailing address:** 3131 ELECTRIC RD STE 100, 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 | NH2578 | VA | Yes |

## Other

- **Enumeration date:** 10/26/2005
- **Last updated:** 11/25/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 227198 | ANTHEM BCBS PPO ID | VA |
| 05 | — | 4953231 | — | VA |
| 01 | — | 608690100 | FEDERAL BLACK LUNG ID | VA |
| 01 | — | C495323 | UNITED AMERICAN INS CO ID | VA |