Provider Demographics
NPI:1356308860
Name:NEXION HEALTH AT VIVIAN, INC.
Entity Type:Organization
Organization Name:NEXION HEALTH AT VIVIAN, INC.
Other - Org Name:VIVAN HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:KIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-552-4800
Mailing Address - Street 1:6937 WARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7454
Mailing Address - Country:US
Mailing Address - Phone:410-552-4800
Mailing Address - Fax:410-552-4837
Practice Address - Street 1:912 S PECAN ST
Practice Address - Street 2:
Practice Address - City:VIVIAN
Practice Address - State:LA
Practice Address - Zip Code:71082-3350
Practice Address - Country:US
Practice Address - Phone:318-375-2203
Practice Address - Fax:318-375-2866
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEXION HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-27
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA825314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1510271Medicaid
LA1510271Medicaid