Villa Feliciana Medical Complex
Organization Active NPI Skilled Nursing Facility · Jackson, LA
NPI 1356508667 · NPPES record last updated Jun 19, 2008
Key facts
- NPI
- 1356508667
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 233 (LA)
- Legal business name
- VILLA FELICIANA MEDICAL COMPLEX
- Practice address
- 5002 Hwy 10
Jackson, LA 70748-0438 - Phone
- (225) 634-4017
- NPI assigned
- May 22, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. James R O Rear
- Title
- Long Term Care Admin
- Phone
- (225) 634-4017
Owners & managing parties with NPI records 2
-
Chaillie P Daniel, M.D.
Other NPIs with the same Medicare PAC ID 1
Member organizations 1
Practitioners 6
-
Marie M Attuso, MD
-
Chaillie P Daniel, M.D.
-
David K Jackson, PHD MSCP
-
Ro Risa Reina, MD
Medicare Care Compare: Nursing home
- Listed as
- Villa Feliciana Chronic Disease
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- Government - State
- Certified
- Jan 1, 1978
- Certified beds
- 299 · 158.9 residents per day on average
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 6 · fines totaling $456,518
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Skilled nursing facility certification: CCN 195150
- Legal name
- VILLA FELICIANA MEDICAL COMPLEX
- Doing business as
- VILLA FELICIANA MEDICAL COMPLEX
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1978
- Last certification
- Nov 7, 2024
- Beds
- 299
- Ownership / control type
- State
- Organization structure
- Other · Non-profit
- Incorporated
- Jan 1, 1967 in LA
- Enrollment address
- 5002 Highway 10
Jackson, LA 70748-3627 - Nursing home name
- VILLA FELICIANA CHRONIC DISEASE
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Chaillie P Daniel |
Operational/Managerial Control | Oct 1, 2022 | |
| Adp of the SNF | Oct 1, 2022 | ||
| Indirect Ownership Interest | Oct 1, 2022 | ||
| Villa Feliciana Medical Complex |
Operational/Managerial Control | Oct 1, 2022 | 100% |
| John Patrick Eckler |
Corporate Director |
Oct 22, 2018 | 100% |
| Operational/Managerial Control |
Oct 22, 2018 | 75% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080520000327 | LA | Part a Provider - Skilled Nursing Facility | 4486546405 | Practice locations: Jackson, LA |
National Provider Directory
Locations
5002 Highway 10
Jackson, LA 70748
Phone (225) 329-9132
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 233 | LA | Yes |
Addresses
Primary practice location
5002 Hwy 10
Jackson, LA 70748-0438
Mailing address
PO Box 438
Jackson, LA 70748-0438
Phone (225) 634-4017
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 195150 | Other | LA | MEDICARE SKILLED - ECF |
Other providers in Jackson, LA
- Tina Marie Stamps
- Salonda Thomas
- Michael Kevin Tomb
- Rhonda Bourgeois Tomb
- Elizabeth Tycer
- Villa Feliciana Medical Complex
- Jacqueline Michel Whitmore
All providers in Jackson, LA · Skilled Nursing Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.