# MARY WASHINGTON CONVALESCENT & NURSING CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mary Washington Rehabilitation & Health Care LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740365394
- **Authorized official:** MR. GRAHAM L ADELMAN (PRESIDENT)
- **Authorized official phone:** (804) 521-0550

## Contact information

- **Practice address:** 2400 MCKINNEY BLVD, COLONIAL BEACH, VA 22443-1237
- **Practice address phone:** (804) 224-2222
- **Practice address fax:** (804) 224-2282
- **Mailing address:** 12093 GAYTON RD, RICHMOND, VA 23238-3401
- **Mailing address phone:** (804) 521-0550
- **Mailing address fax:** (804) 521-0555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2627 | VA | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 139149 | BCBS PROVIDER NUMBER | VA |