Victorian Villa Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AM380392463 Issued in MI

Legal business name

VICTORIAN VILLA ASSISTED LIVING LLC

Practice address

5585 Brooklyn Rd South
Jackson, MI 49201-8570

Phone

(517) 764-4163

NPI assigned

Aug 17, 2018

Organization subpart

No

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

Authorized official

Name

Linda M West, RN

Title

Administrator

Phone

(517) 315-1725

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1386124550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5585 BROOKLYN RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018570",
            "telephone_number": "517-764-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5585 BROOKLYN RD SOUTH",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018570",
            "telephone_number": "517-764-4163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5585 Brooklyn Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492018570",
            "country_code": "US",
            "telephone_number": "517-764-4163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VICTORIAN VILLA ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "517-315-1725",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AM380392463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Jackson, MI
• Providers in Jackson, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.