Organization
CENTERS FOR LONG TERM CARE OF TAPPAHANNOCK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY R TREBERT (CEO)
(817) 359-2000
Entity
Organization
Contact information
Practice address
1150 MARSH ST., TAPPAHANNOCK, VA 22560
(804) 443-4308
(804) 443-6425
Mailing address
PO BOX 155635, FORT WORTH, TX 76155-0635
(817) 359-2000
(817) 359-2093
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4953282
—
VA
Enumeration date
03/15/2006
Last updated
08/22/2020
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