WISE LIFE CARE, LLC (NPI# 1225520232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225520232 |
| Entity Type | Organization |
| Organization Name | WISE LIFE CARE, LLC |
| Other Organization Name | HERITAGE HALL - WISE |
| Practice Address |
9434 Coeburn Mountain Rd Wise VA 24293-5944 |
| Mailing Address |
Po Box 1009 Wise VA 24293-1009 |
| Practice Telephone | 2763282721 |
| Practice Fax Number | 2763281463 |
| Mailing Telephone | 2763282721 |
| Mailing Fax Number | 2763281463 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |
| Authorized Official Name | MR. JAMES L HAINES (CCO & GENERAL COUNSEL) |
| Authorized Official Telephone | 5407744263 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH2583 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FEDERAL BLACK LUNG | 200515608 | 01 | |
| VA | 4953509 | 05 | |
| ANTHEM BCBS | 180512 | 01 |
| Other Name | Type Code |
|---|---|
| Heritage Hall - Wise | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543890 | Wise Life Care, LLC | Skilled Nursing Facility | 9434 Coeburn Mountain Rd, Wise, VA 24293 | 2005-10-26 |
| Street Address |
9434 COEBURN MOUNTAIN RD |
| City | WISE |
| State | VA |
| Zip Code | 24293-5944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543890 | Wise Life Care, LLC | Skilled Nursing Facility | 9434 Coeburn Mountain Rd, Wise, VA 24293 | 2005-10-26 |
| 1669824736 | Lena Lee Whisenhunt | Nurse Practitioner | 9434 Coeburn Mountain Rd, Wise, VA 24293-5944 | 2016-07-12 |
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|---|---|---|---|---|
| 1104442367 | New Hope Addiction Recovery Inc | Family Medicine | 106 Spring Avenue Ne, Wise, VA 24293 | 2020-06-23 |
| 1225652340 | Jessica Wertz | Technician | 7507 Caddo Rd, Wise, VA 24293 | 2020-06-04 |
| 1831743632 | Ttgi2 LLC | Pharmacy | 426 West Main Street, Wise, VA 24293 | 2019-07-30 |
| 1861919730 | Mckenzie Grace Trotter | Speech-Language Pathologist | 324 School Ave Southeast, Wise, VA 24293 | 2017-08-23 |
| 1043734023 | 3 Guys Transport LLC | Non-emergency Medical Transport (VAN) | 5519 Pole Bridge Road, Wise, VA 24293 | 2017-08-01 |
| 1013352699 | Tester Chiropractic LLC. | Chiropractor | 411 East Main Street, Wise, VA 24293 | 2013-05-08 |
| 1861737181 | Family Preservation Services, Inc | Community/Behavioral Health | 5913 Airport Road, Wise, VA 24293 | 2012-11-28 |
| 1255614749 | Family Preservation Services, Inc | Community/Behavioral Health | 342 School Street, Wise, VA 24293 | 2011-09-21 |
| 1891013520 | Wise Rescue Squad Inc | Ambulance | 302 Railroad Ave, Wise, VA 24293 | 2010-05-05 |
| 1477784148 | Family Preservation Services, Inc. | Community/Behavioral Health | 117 Independence Avenue, Wise, VA 24293 | 2009-07-29 |
| Find all providers in zip 24293 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543890 | Wise Life Care, LLC | Skilled Nursing Facility | 9434 Coeburn Mountain Rd, Wise, VA 24293 | 2005-10-26 |
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|---|---|---|---|---|
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| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.