Organization
BON SECOURS MARYVIEW NURSING CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY RALSTON (SYSTEM DIRECTOR)
(419) 996-5119
Entity
Organization
Contact information
Practice address
4775 BRIDGE RD, SUFFOLK, VA 23435-2045
(757) 686-0488
(757) 686-8211
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5573
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH2511
VA
314000000X
Skilled Nursing Facility
Primary
NH2511
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4952065
—
VA
Enumeration date
07/30/2006
Last updated
10/22/2020
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