Provider Demographics
NPI:1962873927
Name:SHAMIN-HOPEWELL ASSISTED LIVING
Entity type:Organization
Organization Name:SHAMIN-HOPEWELL ASSISTED LIVING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:P
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:804-796-2038
Mailing Address - Street 1:2000 WARE BOTTOM SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-4200
Mailing Address - Country:US
Mailing Address - Phone:804-796-2038
Mailing Address - Fax:804-796-2394
Practice Address - Street 1:5301 PLAZA DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-7305
Practice Address - Country:US
Practice Address - Phone:804-458-5830
Practice Address - Fax:804-458-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALF1058375310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility