Provider Demographics
NPI:1972159861
Name:CROZET OPERATIONS LLC
Entity type:Organization
Organization Name:CROZET OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHFOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-823-4307
Mailing Address - Street 1:1220 CROZET AVE
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-3163
Mailing Address - Country:US
Mailing Address - Phone:434-832-4307
Mailing Address - Fax:855-831-9821
Practice Address - Street 1:1220 CROZET AVE
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3163
Practice Address - Country:US
Practice Address - Phone:434-832-4307
Practice Address - Fax:855-831-9821
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROZET OPERATIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility