Organization
VIDELL HEALTHCARE DUFFIELD LLC
Active
Other names
Ridgecrest Manor Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN D MACE RN DCS (EXEC VICE PRES)
(253) 277-3197
Entity
Organization
Contact information
Practice address
157 ROSS CARTER BLVD, DUFFIELD, VA 24244-5116
(276) 431-2841
(276) 431-2345
Mailing address
157 ROSS CARTER BLVD, DUFFIELD, VA 24244-0280
(276) 431-2841
(276) 431-4718
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2664
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4951344
—
VA
05
—
4960386
—
VA
Enumeration date
07/26/2006
Last updated
11/15/2012
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