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Organization

BLACKSBURG LIFE CARE, LLC

Active
Other names
Heritage Hall - Blacksburg
Organization subpart
No

Provider details

NPI number
Authorized official
CASSANDRA GALLANT (COMPLIANCE & PRIVACY OFFICER)
(540) 774-4263
Entity
Organization

Contact information

Practice address
3610 S MAIN ST, BLACKSBURG, VA 24060
(540) 951-7000
(540) 951-4109
Mailing address
3131 ELECTRIC RD, ROANOKE, VA 24018-6427
(540) 774-4263
(540) 774-0780

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2569
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180503
ANTHEM BCBS PROVIDER ID
VA
01
200515600
FEDERAL BLACK LUNG
VA
05
4953568
VA
Enumeration date
10/26/2005
Last updated
05/08/2026
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