Provider Demographics
NPI:1306004643
Name:SACRED HEART VILLA
Entity Type:Organization
Organization Name:SACRED HEART VILLA
Other - Org Name:ST. MICHAEL CONVENT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-929-5751
Mailing Address - Street 1:51 SEMINARY AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-2766
Mailing Address - Country:US
Mailing Address - Phone:610-929-5751
Mailing Address - Fax:610-929-0762
Practice Address - Street 1:51 SEMINARY AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-2766
Practice Address - Country:US
Practice Address - Phone:610-929-5751
Practice Address - Fax:610-929-0762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISSIONARY SISTERS OF THE SACRED HEART OF JESUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA206190310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility