Organization Name: | VILLA PINES LIVING CENTER |
NPI Number: | 1518086305 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICKI GRANT (FACILITY ADMINISTRATOR) |
Mailing Address: | 201 S Park Ave Friendship |
State: | WI US |
Postal Code: | 539349377 |
Phone Number: | 6083393361 |
Fax Number: | 6083399468 |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6457-024 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |