Organization
WOODBINE CONVALESCENT & NURSING CARE LLC
Active
Other names
Woodbine Rehabilitation & Healthcare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRAHAM L ADELMAN (PRESIDENT)
(804) 521-0550
Entity
Organization
Contact information
Practice address
2729 KING ST, ALEXANDRIA, VA 22302-4008
(703) 836-8838
(703) 836-2965
Mailing address
12093 GAYTON RD, RICHMOND, VA 23238-3401
(804) 521-0550
(804) 521-0555
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2732
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312386
MAMSI/OCI PROVIDER NUMBER
VA
01
—
GU8
BCBS PROVIDER NUMBER
VA
Enumeration date
10/25/2006
Last updated
08/22/2020
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