# VILLA MARIA CARE CENTER, LLC

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

## Provider details

- **NPI number:** 1902953813
- **Authorized official:** TERRY MCNELLIS (OWNER)
- **Authorized official phone:** (612) 991-9062

## Contact information

- **Practice address:** 4310 E GRANT RD, TUCSON, AZ 85712-2607
- **Practice address phone:** (602) 368-8203
- **Practice address fax:** (602) 368-8211
- **Mailing address:** 4310 E GRANT RD, TUCSON, AZ 85712-2607
- **Mailing address phone:** (520) 323-9351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | ALC4564 | AZ | — |
| 314000000X | Skilled Nursing Facility | NCI263 | AZ | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 09/08/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 566292 | — | AZ |
| 05 | — | 618324 | — | AZ |