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Organization

VCNCL, LLC

Active
Other names
Vineyard Court Nursing Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID ROTOLO (MEMBER)
(601) 853-2667
Entity
Organization

Contact information

Practice address
2002 5TH ST N, COLUMBUS, MS 39705-2208
(662) 328-1133
(662) 328-0774
Mailing address
PO BOX 2712, RIDGELAND, MS 39158-2712
(601) 853-2667
(601) 853-2116

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
183
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00230082
MS
Enumeration date
11/20/2006
Last updated
02/20/2008
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