- Enrollment id
- O20160523000236
- Enrollment state
- VA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1669834032
- Multiple npi flag
- N
- Ccn
- 495267
- Associate id
- 3375832983
- Organization name
- WARRENTON OPERATIONS LLC
- Doing business as name
- BROOKSIDE REHAB AND NURSING CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BROOKSIDE REHAB & NURSING CENTER
- Affiliation entity name
- HILL VALLEY HEALTHCARE
- Affiliation entity id
- 270
- Address line 1
- 614 HASTINGS LN
- City
- WARRENTON
- State
- VA
- Zip code
- 201862110