| Name | Value |
|---|---|
| PROVIDER TYPE | Nursing Service Related Providers |
| CLASSIFICATION | Nursing Home Administrator |
| DEFINITION | An individual, often licensed by the state, who is responsible for the management of a nursing home. |
| STATUS | Active |
| VA CODE | V170500 |
| X12 CODE | 376G00000X |
| SPECIALTY CODE | A1 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5253065 |
| EFFECTIVE DATE/TIME |
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