Vista Grande Villa in Jackson - Skilled Nursing Facility
Vista Grande Villa - NPI 1477537397
Vista Grande Villa is a Skilled Nursing Facility in Jackson, Michigan. Vista Grande Villa practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Vista Grande Villa is 1477537397. The last update date is 2011-11-29.
Vista Grande Villa's current location address is 2251 Springport Rd, Jackson, Michigan. You can contact this provider via phone number 5177870222 and fax number 5177876909. The mailing address for Vista Grande Villa is 2251 Springport Rd, Jackson, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Vista Grande Villa |
|---|---|
| Address | 2251 Springport Rd, Jackson, Michigan |
| Phone Number | 5177870222 |
| Fax Number | 5177876909 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Keatley A. Ellen |
| Telephone Number | 5177870222 |
NPI Number Detail
| NPI Number | 1477537397 |
|---|---|
| Provider Enumeration Date | 2005-12-05 |
| Last Updated Date | 2011-11-29 |
Provider Mailing Address Detail
| Address | 2251 Springport Rd |
|---|---|
| City | Jackson |
| State | Michigan (MI) |
| Post Code | 492021496 |
| Phone Number | 5177870222 |
| Fax Number | 5177876909 |
Provider's Primary Taxonomy Detail
| Speciality | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | 384210 |
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Definition: (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 serv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9716 | MI | BLUE CROSS BLUE SH. OF MI | |
| 2081106 | MI | -- |
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What is the unique identification code assigned to Vista Grande Villa by the Centers for Medicare & Medicaid Services?
The Vista Grande Villa has been issued the NPI (National Provider Identifier) 1477537397. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Vista Grande Villa located?
The Vista Grande Villa is located at 2251 Springport Rd, Jackson, MI 492021496.
What is the Vista Grande Villa's area of specialization and corresponding taxonomy classification?
The Vista Grande Villa's specialty field is Skilled Nursing Facility, and it falls under the taxonomy code 314000000X, which categorizes healthcare providers based on their specialties.
When did the Vista Grande Villa receive its 1477537397?
The Vista Grande Villa was issued its 1477537397 on 2005-12-05, which is the date when the organization was assigned this unique identifier.
As of what date were the Vista Grande Villa's details last updated?
The information pertaining to the Vista Grande Villa, including its address, specialty, and other details, was most recently updated on 2011-11-29.