THE BLAKE AT CHARLOTTESVILLE SERVICES, LLC
NPI 1679265482
Assisted Living Facility - Assisted Living, Behavioral Disturbances in Charlottesville, VA

Q: What is The Blake At Charlottesville Services, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Behavioral Disturbances, with taxonomy code 3104A0630X.

Active since May 22, 2023CLIA 49D2190737 · Waiver

250 NICHOLS COURT, CHARLOTTESVILLE, VA 22901(434) 973-7900(434) 328-7315 Get Directions Write a Review

NPPES record last updated: May 22, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About The Blake At Charlottesville Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE BLAKE AT CHARLOTTESVILLE SERVICES, LLC (NPI 1679265482), doing business as The Blake At Charlottesville, Llc, is a healthcare organization registered as an assisted living, behavioral disturbances in Charlottesville, Virginia and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through August 18, 2026 and lists David Crandall Ter Borg, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1679265482

Entity TypeOrganization

Primary Taxonomy3104A0630X

Legal Business NameTHE BLAKE AT CHARLOTTESVILLE SERVICES, LLC

Location Address250 NICHOLS COURTCharlottesville, VA 22901

Mailing Address250 Nichols CourtCharlottesville, VA 22901 · (434) 973-7900 · Fax (434) 328-7315

Phone(434) 973-7900

Fax(434) 328-7315

Organization SubpartNo

Authorized OfficialDavid Crandall Ter BorgExecutive Director · (434) 973-7900

Enumeration DateMay 22, 2023

NPPES CertifiedMay 22, 2023

✔ NPI 1679265482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Behavioral DisturbancesNursing & Custodial Care Facilities

Taxonomy Code3104A0630X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.

250 NICHOLS COURT, Charlottesville, VA 22901

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Other Names 1

Former Legal Business NameThe Blake At Charlottesville, Llc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2190737

The Blake At Charlottesville · Charlottesville, VA

Active · expires Aug 18, 2026

CLIA Number49D2190737

Laboratory TypeAssisted Living Facility

Certificate Effective DateAugust 19, 2024

Certificate Expiration DateAugust 18, 2026

Laboratory DirectorGayle B. Cox

Laboratory Phone(434) 973-7900

Laboratory LocationThe Blake At Charlottesville250 Nichols Court, Charlottesville, VA 22901

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Blake At Charlottesville Services, LLC's NPI number?

The NPI number for The Blake At Charlottesville Services, LLC is 1679265482. It was assigned to this organization in the NPPES registry on May 22, 2023. The provider was formerly known as The Blake at Charlottesville, LLC.

Where is The Blake At Charlottesville Services, LLC located?

The Blake At Charlottesville Services, LLC is located at 250 Nichols Court, Charlottesville, VA 22901. The listed phone number is (434) 973-7900.

What is The Blake At Charlottesville Services, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Behavioral Disturbances, with taxonomy code 3104A0630X.

Does The Blake At Charlottesville Services, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2190737) is associated with this NPI, valid through August 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Blake At Charlottesville Services, LLC was last updated on May 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.