# BROC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BLUE RIDGE NURSING CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770806291
- **Authorized official:** MRS. DORENE M FORD (DIRECTOR OF M.I.S.)
- **Authorized official phone:** (239) 963-3400

## Contact information

- **Practice address:** 300 BLUE RIDGE ST, MARTINSVILLE, VA 24112-7261
- **Practice address phone:** (276) 638-8701
- **Practice address fax:** (276) 638-8843
- **Mailing address:** 1400 CENTREPARK BLVD STE 810, WEST PALM BEACH, FL 33401-7412
- **Mailing address phone:** (239) 963-3400
- **Mailing address fax:** (239) 963-3410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/11/2010
- **Last updated:** 05/11/2018