Organization
301 VILLAGE HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARUCH GIBERSTIEN (MANAGING MEMBER)
(443) 415-8090
Entity
Organization
Contact information
Practice address
301 VILLAGE CIR, BRISTOL, VA 24201-8302
(276) 477-5334
Mailing address
301 VILLAGE CIR, BRISTOL, VA 24201-8302
(276) 477-5334
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528712387
ANTHEM HEALTH KEEPERS PLUS
VA
05
—
NH2783
—
VA
Enumeration date
02/09/2022
Last updated
02/23/2023
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