Vista Grande Villa

LBN: Vista Grande Villa
Vista Grande Villa is an health care organization with primary practice located at 2251 Springport Rd , Jackson MI 49202-1496. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Vista Grande Villa can be contacted via phone (517) 787-0222, or through Keatley, Ellen A. via phone (517) 787-0222.

Contact Information

Primary practice address
2251 Springport Rd Jackson MI 49202-1496
Phone: (517) 787-0222
Fax: (517) 787-6909
Website:
Map and Directions
Authorized official contact:
Name: Keatley, Ellen A.
Phone: (517) 787-0222

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 384210 Michigan

Profile Details

NPI number 1477537397
LBN Legal business name Vista Grande Villa
DBA Doing business as
Authorized official Keatley, Ellen A.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 5th, 2005
Last updated Nov 29th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477537397 NPPES
Michigan Other 09716 BLUE CROSS BLUE SH. OF MI
Michigan MEDICAID 2081106 BLUE CROSS BLUE SH. OF MI

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