THE VILLAS OF JACKSON LLC (NPI# 1215438585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215438585 |
| Entity Type | Organization |
| Organization Name | THE VILLAS OF JACKSON LLC |
| Practice Address |
670 Broadridge Jackson MO 63755 |
| Practice Telephone | 5739868210 |
| Practice Fax Number | 5737555155 |
| Mailing Telephone | 5739868210 |
| Mailing Fax Number | 5737555155 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | MR. CARL MARTIN KNOTT (ADMINISTRATOR) |
| Authorized Official Telephone | 5739868210 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 045129 | MO | Nursing & Custodial Care Facilities |
| Street Address |
670 BROADRIDGE |
| City | JACKSON |
| State | MO |
| Zip Code | 63755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1346637865 | Vitality Clinic | Health Educator | 111 N. Missouri Street, Jackson, MO 63755 | 2015-04-22 |
| 1144569567 | Rock Care In Home Services, LLC | Nursing Care | 204 S Union Ave, Jackson, MO 63755 | 2013-02-05 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1154689321 | Benjamin Gail Goodier | Dentist | 3100 East Jackson Blvd., Jackson, MO 63755 | 2012-04-25 |
| 1912278987 | Guardian Angels Homecare, LLC | Nursing Care | 1335 Old Cape Rd., Suite F, Jackson, MO 63755 | 2012-01-23 |
| 1528357829 | Sydney Nicole Cheek | Technician, Other | 107 Cottonwood St., Jackson, MO 63755 | 2011-04-07 |
| 1215162920 | Troy L Bell Od & Associates, PC | Optometrist | 2594 E Jackson Blvd, Jackson, MO 63755 | 2009-05-26 |
| 1932398021 | Immediate Healthcare, Inc. | General Practice | 1508 Edgemont Blvd, Perryville, MO 63755 | 2007-10-15 |
| 1134315591 | Catherine Montano Alipala | Occupational Therapist | 115 K-land Drive, Jackson, MO 63755 | 2007-09-19 |
| Find all providers in zip 63755 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598377905 | Nohc Jackson Senior Living LLC | Assisted Living Facility | N16744 Eagle Drive, Jackson, WI 53037 | 2020-08-18 |
| 1952924706 | Snh Se Tenant Trs, Inc | Assisted Living Facility | N168w22022 Main St, Jackson, WI 53037-9469 | 2020-05-27 |
| 1386124550 | Victorian Villa Assisted Living LLC | Assisted Living Facility | 5585 Brooklyn Rd South, Jackson, MI 49201-8570 | 2018-08-17 |
| 1912455361 | Victorious Healthcare L.L.C. | Assisted Living Facility | 4959 Laurel Oak Dr, Jackson, MS 39212-2150 | 2016-09-14 |
| 1265816433 | Open Arms Personal Care Home | Assisted Living Facility | 539 Claiborne Ave, Jackson, MS 39209-5340 | 2015-07-16 |
| 1629405121 | Ec Jackson Operations, LLC | Assisted Living Facility | 911 Old Humboldt Rd, Jackson, TN 38305-5668 | 2013-09-30 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1740522135 | Harmony Court Assisted Living Home Inc | Assisted Living Facility | 5411 I 55 N, Jackson, MS 39206-3616 | 2013-03-23 |
| 1215225149 | House of Faith LLC | Assisted Living Facility | 928 Hunt St, Jackson, MS 39203-2908 | 2011-07-12 |
| 1528359189 | Shanell's Residential Care Home, Inc. | Assisted Living Facility | 4022 California Ave, Jackson, MS 39213-5513 | 2011-04-29 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.