Organization
SP LAFAYETTE VILLA LLC
Active
Other names
Tandem Health Care of Norfolk
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CONTE (CHIEF OPERATING OFFICER)
(407) 571-1550
Entity
Organization
Contact information
Practice address
3900 LLEWELLYN AVE, NORFOLK, VA 23504-1203
(757) 625-5363
(757) 627-3161
Mailing address
800 CONCOURSE PKWY S, SUITE 200, MAITLAND, FL 32751-6148
(407) 571-1550
(407) 571-1599
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4952731
—
VA
Enumeration date
06/11/2006
Last updated
08/22/2020
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