Villa Haven Health & Rehabilitation Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

004773 Issued in TX

Legal business name

VILLA HAVEN HEALTH & REHABILITATION CENTER

Practice address

300 S Jackson St
Breckenridge, TX 76424-4804

Phone

(254) 559-3386

Fax

(254) 559-7259

NPI assigned

Aug 24, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John Lake Degrand, SNF ADMINISTRATOR

Title

Administrator

Phone

(254) 559-3386

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821081977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244804",
            "telephone_number": "254-559-3386",
            "fax_number": "254-559-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244804",
            "telephone_number": "254-559-3386",
            "fax_number": "254-559-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA HAVEN HEALTH & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEGRAND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LAKE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "254-559-3386",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SNF ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "004773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Breckenridge, TX
• Providers in Breckenridge, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.