# VILLA FELICIANA MEDICAL COMPLEX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356508667
- **Authorized official:** MR. JAMES R O REAR (LONG TERM CARE ADMIN)
- **Authorized official phone:** (225) 634-4017

## Contact information

- **Practice address:** 5002 HWY 10, JACKSON, LA 70748-0438
- **Practice address phone:** (225) 634-4017
- **Mailing address:** PO BOX 438, JACKSON, LA 70748-0438
- **Mailing address phone:** (225) 634-4017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 233 | LA | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 06/19/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 195150 | MEDICARE SKILLED - ECF | LA |