Organization
MASONIC HOME OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES D COLE (CEO)
(804) 222-1694
Entity
Organization
Contact information
Practice address
4101 NINE MILE RD, RICHMOND, VA 23223-4956
(804) 222-1694
(804) 226-4567
Mailing address
4101 NINE MILE RD, RICHMOND, VA 23223-4956
(804) 222-1694
(804) 226-4567
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH2628
VA
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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