Vista Grande Villa
Skilled Nursing Facility in Jackson, MI. Organization (NPI-2).
NPI number1477537397
StatusActive
Last updated in NPPESNov 29, 2011
Details
- NPI
- 1477537397
- Entity type
- Organization (NPI-2)
- Legal business name
- Vista Grande Villa
- Organization subpart
- No
- Enumeration date
- Dec 5, 2005
- Last updated
- Nov 29, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 384210 | MI | Yes |
Practice location
2251 Springport RdJackson, MI 49202-1496
Phone 517-787-0222 · Fax 517-787-6909
Mailing address
2251 Springport RdJackson, MI 49202-1496
Phone 517-787-0222 · Fax 517-787-6909
Authorized official
Ellen A. Keatley
President
5177870222
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