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Organization
THE LAURELS OF UNIVERSITY PARK, LLC
Active
Organization
THE LAURELS OF UNIVERSITY PARK, LLC
Active
Other names
THE LAURELS OF UNIVERSITY PARK
Organization subpart
No
Provider details
NPI number
Authorized official
ANIS KHAN (CFO)
(614) 794-8800
Entity
Organization
Contact information
Practice address
2420 PEMBERTON RD, RICHMOND, VA 23233-2006
(804) 747-9200
(804) 747-1574
Mailing address
2420 PEMBERTON RD, RICHMOND, VA 23233-2006
(804) 747-9200
(804) 747-1574
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH2705
VA
314000000X
Skilled Nursing Facility
Primary
NH2705
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004951093
—
VA
01
—
NH2705
NURSING HOME LICENSE #
VA
Enumeration date
08/31/2006
Last updated
01/03/2017
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