Villa at Bryn Mawr LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

VILLA AT BRYN MAWR LLC

Practice address

275 Penn Ave N
Minneapolis, MN 55405-1216

Phone

(612) 377-4723

Fax

(612) 377-0294

NPI assigned

Apr 19, 2013

Last updated

Mar 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Israel

Title

Director

Phone

(847) 440-2655

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1780028878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 W LUNT AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122615",
            "telephone_number": "847-440-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051216",
            "telephone_number": "612-377-4723",
            "fax_number": "612-377-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA AT BRYN MAWR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-440-2655"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Village Home Care
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• Skilled Nursing Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.