Provider Demographics
NPI:1922244748
Name:VILLA VENTURA RESIDENTIAL CARE FACILITY
Entity Type:Organization
Organization Name:VILLA VENTURA RESIDENTIAL CARE FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ASSISTED LIVING
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-941-0525
Mailing Address - Street 1:12100 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1764
Mailing Address - Country:US
Mailing Address - Phone:816-941-0525
Mailing Address - Fax:816-941-4062
Practice Address - Street 1:12100 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145-1764
Practice Address - Country:US
Practice Address - Phone:816-941-0525
Practice Address - Fax:816-941-4062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEMINI VILLA VENTURA L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO036224310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility