Provider Demographics
NPI:1225068232
Name:CENTURY VILLAS, INC.
Entity Type:Organization
Organization Name:CENTURY VILLAS, INC.
Other - Org Name:CENTURY VILLA HEALTH CARE & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEMLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:765-628-3377
Mailing Address - Street 1:705 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46936-1246
Mailing Address - Country:US
Mailing Address - Phone:765-628-3377
Mailing Address - Fax:765-628-3950
Practice Address - Street 1:705 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:IN
Practice Address - Zip Code:46936-1246
Practice Address - Country:US
Practice Address - Phone:765-628-3377
Practice Address - Fax:765-628-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060005491314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100267470AMedicaid
IN000000097938OtherANTHEM
IN155510Medicare ID - Type UnspecifiedMEDICARE NUMBER
IN100267470AMedicaid