NPI 1114551116

Ebenezer Rest Home LLC

Organisation Assisted Living Facility (Behavioral Disturbances) Triangle, VA

Practice location

Address: 18909 Red Oak Ln, Triangle, VA 22172-2122
Phone: (812) 447-2707

Authorised official

Name: Jane F Namulondo
Title: Owner
Phone: (781) 244-7270

Registered specialties

Assisted Living Facility (Behavioral Disturbances) Primary

Nursing & Custodial Care Facilities Taxonomy 3104A0630X

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Registry record

NPI: 1114551116
Entity type: Organization
NPI issued: 27 Feb 2020
Record last updated: 27 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.