NPIMap

Organization Active NPI

Villa Belle Moon Assisted Living Inc

  • Assisted Living Facility
  • Rockville, MD
National Provider Identifier
1891070645
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
15AL0446-A Issued in MD
Legal business name
VILLA BELLE MOON ASSISTED LIVING INC
Practice address
6305 Tuckerman LN
Rockville, MD 20852-3511
Phone
(240) 463-7196
NPI assigned
Oct 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Authorized official

Name
Mrs. Marie Mona Vivens, R.N
Title
Assisted Living Manager
Phone
(240) 644-8399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 15AL0446-A MD Primary

Addresses

Primary practice location

6305 Tuckerman LN
Rockville, MD 20852-3511

Mailing address

6305 Tuckerman LN
Rockville, MD 20852-3511
Phone (240) 463-7196

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1891070645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6305 TUCKERMAN LN",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523511",
            "telephone_number": "240-463-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 TUCKERMAN LN",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523511",
            "telephone_number": "240-463-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA BELLE MOON ASSISTED LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "VIVENS",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "MONA",
        "authorized_official_title_or_position": "ASSISTED LIVING MANAGER",
        "authorized_official_telephone_number": "240-644-8399",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "15AL0446-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.