Organization
WC-GRANVILLE VILLA OPS, LLC
Active
Other names
Granville Villa Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
COLLETTE MIERES (EXECUTIVE DIRECTOR)
(402) 933-6405
Entity
Organization
Contact information
Practice address
8507 GRANVILLE PKWY, LA VISTA, NE 68128-3212
(402) 933-6405
(402) 505-9144
Mailing address
8507 GRANVILLE PKWY, LA VISTA, NE 68128-3212
(402) 933-6405
(402) 505-9144
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/29/2014
Last updated
02/06/2015
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