BLACKSTONE LIFE CARE, LLC (NPI# 1326038720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326038720 |
| Entity Type | Organization |
| Organization Name | BLACKSTONE LIFE CARE, LLC |
| Other Organization Name | HERITAGE HALL - BLACKSTONE |
| Practice Address |
900 S Main St Blackstone VA 23824 |
| Mailing Address |
3131 Electric Rd Roanoke VA 24018-6427 |
| Practice Telephone | 4342925301 |
| Practice Fax Number | 4342926041 |
| Mailing Telephone | 5407744263 |
| Mailing Fax Number | 5407740780 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2018-07-06 |
| Authorized Official Name | MR. JAMES L HAINES (CCO & GENERAL COUNSEL) |
| Authorized Official Telephone | 5407744263 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH2570 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM BCBS PROVIDER ID | 180505 | 01 |
| VA | FEDERAL BLACK LUNG ID | 200515603 | 01 |
| VA | 4953533 | 05 |
| Other Name | Type Code |
|---|---|
| Heritage Hall - Blackstone | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215429386 | Blackstone Life Care, LLC | Skilled Nursing Facility | 900 S Main St, Blackstone, VA 23824-2644 | 2018-06-04 |
| Street Address |
900 S MAIN ST |
| City | BLACKSTONE |
| State | VA |
| Zip Code | 23824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215429386 | Blackstone Life Care, LLC | Skilled Nursing Facility | 900 S Main St, Blackstone, VA 23824-2644 | 2018-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447667753 | William White Jr. | Physician Assistant | Building 1876 Fort Pickett, Virginia Army National Guard, Blackstone, VA 23824 | 2014-07-18 |
| 1114248788 | Precious R. White | Physical Therapy Assistant | 703 Falls St., Blackstone, VA 23824 | 2010-06-18 |
| 1720224991 | Family Preservation Services, Inc | Community/Behavioral Health | 615, Blackstone, VA 23824 | 2008-12-18 |
| 1053440453 | Rhonda Daniels Wynder | Physician Assistant | Jfhq Medical Command, Bldg 306, Fort Pickett, VA 23824 | 2007-03-04 |
| 1578651097 | Commonwealth Vision Center P.C. | Optometrist | 1447 South Main Street, Blackstone, VA 23824 | 2006-10-10 |
| 1548293194 | Bon Secours-virginia Healthsource | Family Medicine | 213 N Main St, Blackstone, VA 23824 | 2006-07-08 |
| 1134610918 | Bennett Logistics, LLC | Transportation Broker | 212 Gravatt Ave, Blackstone, VA 23824-1210 | 2018-05-28 |
| 1700266277 | Jan's Residential Homes | Community Based Residential Treatment Facility, Mental Illness | 307 N High St, Blackstone, VA 23824-1421 | 2015-05-31 |
| 1982670261 | James L. Bradshaw | Dentist | 131 N Main St, Blackstone, VA 23824-1423 | 2006-02-27 |
| 1235125360 | Spencer's Drug Store, Inc. | Durable Medical Equipment & Medical Supplies | 100 N Main St, Blackstone, VA 23824-1424 | 2005-09-23 |
| Find all providers in zip 23824 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164583589 | 8 Butler St., Inc. | Skilled Nursing Facility | 8 Butler St, Blackstone, MA 01504-1541 | 2006-12-12 |
| 1215429386 | Blackstone Life Care, LLC | Skilled Nursing Facility | 900 S Main St, Blackstone, VA 23824-2644 | 2018-06-04 |
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|---|---|---|---|---|
| 1760015119 | Mikaylah Lang | Skilled Nursing Facility | 4505 Georgewashington Hwy, Portsmouth, VA 23702 | 2020-02-13 |
| 1134760432 | Valley Operator LLC | Skilled Nursing Facility | 940 E Lee Hwy, Chilhowie, VA 24319-3237 | 2019-10-08 |
| 1871134171 | Westport Operator LLC | Skilled Nursing Facility | 7300 Forest Ave, Richmond, VA 23226-3735 | 2019-10-08 |
| 1437790730 | Hopewell Operator LLC | Skilled Nursing Facility | 905 Cousins Ave, Hopewell, VA 23860-6507 | 2019-10-08 |
| 1013478411 | Blue Ridge Snf Operations LLC | Skilled Nursing Facility | 105 Landmark Dr, Stuart, VA 24171-9401 | 2019-03-28 |
| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
| Find all providers with the same taxonomy | ||||
| City | BLACKSTONE |
| Zip Code | 23824 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.