- Enrollment id
- O20221215003064
- Enrollment state
- VA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1750001020
- Multiple npi flag
- N
- Ccn
- 495361
- Associate id
- 6800265794
- Organization name
- BELMONT BAY OPERATOR, LLC
- Doing business as name
- BELMONT BAY REHABILITATION AND HEALTHCARE CENTER
- Incorporation date
- 2022-07-26
- Incorporation state
- VA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BELMONT BAY REHABILITATION AND HEALTHCARE CENTER
- Affiliation entity name
- MARQUIS HEALTH SERVICES
- Affiliation entity id
- 336
- Address line 1
- 14906 RICHMOND HWY
- City
- WOODBRIDGE
- State
- VA
- Zip code
- 221914016