Organization
VICTORIAN VILLA ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA M WEST RN (ADMINISTRATOR)
(517) 315-1725
Entity
Organization
Contact information
Practice address
5585 BROOKLYN RD SOUTH, JACKSON, MI 49201-8570
(517) 764-4163
Mailing address
5585 BROOKLYN RD, JACKSON, MI 49201-8570
(517) 764-4163
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AM380392463
MI
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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