NPIMap

Organization Active NPI

Villa Maria

Doing business as Villa Maria Adult DayCare

  • Skilled Nursing Facility
  • Fargo, ND
National Provider Identifier
1144485608
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1023B Issued in ND
Legal business name
VILLA MARIA
Doing business as
Villa Maria Adult DayCare
Practice address
3102 University Dr S
Fargo, ND 58103-6004
Phone
(701) 293-7750
Fax
(701) 293-5845
NPI assigned
Jul 24, 2008
Last updated
Apr 16, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SISTERS OF MARY OF THE PRESENTATION LONG TERM CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Meldine Kay Tang
Title
Chief Financial Officer
Phone
(701) 277-7999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1023B ND Primary

Addresses

Primary practice location

3102 University Dr S
Fargo, ND 58103-6004

Mailing address

3102 University Dr S
Fargo, ND 58103-6004
Phone (701) 293-7750

Other identifiers 1

IdentifierTypeStateIssuer
033120MedicaidND

Other names 1

  • Villa Maria Adult DayCare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sisters of Mary of the Presentation Long-Term Care9 organizations share this tax ID, including this one
Part of
Sisters of Mary of the Presentation Long-Term Care

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1144485608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036004",
            "telephone_number": "701-293-7750",
            "fax_number": "701-293-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036004",
            "telephone_number": "701-293-7750",
            "fax_number": "701-293-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA MARIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE",
        "enumeration_date": "2008-07-24",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "TANG",
        "authorized_official_first_name": "MELDINE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "701-277-7999"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1023B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033120",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Maria Adult DayCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Villa Maria Adult DayCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.