Organization
AUTUMN CORPORATION
Active
Other names
Autumn Care of Altavista
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM I. WEISBERG (VICE PRESIDENT)
(216) 292-5706
Entity
Organization
Contact information
Practice address
1317 LOLA AVE, ALTAVISTA, VA 24517-1352
(434) 369-6651
(434) 309-7254
Mailing address
26691 RICHMOND RD, BEDFORD HEIGHTS, OH 44146-1421
(216) 292-5706
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
NH2483
VA
314000000X
Skilled Nursing Facility
Primary
NH2483
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4951964
—
VA
Enumeration date
12/15/2005
Last updated
01/21/2019
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