Provider Demographics
NPI:1417434994
Name:VILLAS DEL SOL
Entity Type:Organization
Organization Name:VILLAS DEL SOL
Other - Org Name:VILLAS DEL SOL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-834-9130
Mailing Address - Street 1:520 EAST RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-3005
Mailing Address - Country:US
Mailing Address - Phone:915-307-2011
Mailing Address - Fax:915-261-7565
Practice Address - Street 1:520 EAST RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-3005
Practice Address - Country:US
Practice Address - Phone:915-307-2011
Practice Address - Fax:915-261-7565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
149975310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility