Provider Demographics
NPI:1912166091
Name:VILLA MARIA NURSING & REHABILITATION CENTER
Entity Type:Organization
Organization Name:VILLA MARIA NURSING & REHABILITATION CENTER
Other - Org Name:VILLA MARIA WEST SKILLED NURSING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:CATANIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-484-1515
Mailing Address - Street 1:4790 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5860
Mailing Address - Country:US
Mailing Address - Phone:954-484-1515
Mailing Address - Fax:954-484-5416
Practice Address - Street 1:8850 NW 122ND ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1748
Practice Address - Country:US
Practice Address - Phone:305-731-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF130471041314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility