CONCORDIA ASSISTED LIVING - NANSEMOND COMMONS
NPI 1053836726
Assisted Living Facility in Suffolk, VA

Q: What is the provider's specialty?

The provider's specialty is Assisted Living Facility with taxonomy code 310400000X.

Active since August 03, 2017

200 W CONSTANCE RD, SUFFOLK, VA 23434(757) 539-8744(757) 539-6128 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Aug 3, 2017 (2 updates tracked since 2017).

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NPI Profile Information
Primary Taxonomy
Authorized Official
Other Providers Same Location
Frequently Asked Questions

Organization
Assisted Living Facility

About CONCORDIA ASSISTED LIVING - NANSEMOND COMMONS

This page provides the complete NPI Profile along with additional information for Concordia Assisted Living - Nansemond Commons, a provider established in Suffolk, Virginia operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1053836726 assigned on August 2017. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Concordia Assisted Living - Nansemond Commons. The authorized official of this NPI record is Bent Philipson (Managing Member)

NPI: 1053836726 Verify this NPI
Provider Legal Name: EAGLE ACQUISITION XV LLC
Other Organization Name: CONCORDIA ASSISTED LIVING - NANSEMOND COMMONS
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 200 W CONSTANCE RD SUFFOLK, VA 23434
Location Phone: (757) 539-8744
Location Fax: (757) 539-6128
Mailing Address: 200 W CONSTANCE RD SUFFOLK, VA 23434
Mailing Phone: (757) 539-8744
Mailing Fax: (757) 539-6128
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 08-03-2017
Last Update Date: 07-21-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Assisted Living Facility
Taxonomy Code: 310400000X
Type: Nursing & Custodial Care Facilities
Taxonomy Description: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: BENT PHILIPSON
Authorized Official Title: MANAGING MEMBER
Authorized Official Phone: (516) 869-3700