Organization
VILLA MARIA CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY MCNELLIS (OWNER)
(612) 991-9062
Entity
Organization
Contact information
Practice address
4310 E GRANT RD, TUCSON, AZ 85712-2607
(602) 368-8203
(602) 368-8211
Mailing address
4310 E GRANT RD, TUCSON, AZ 85712-2607
(520) 323-9351
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
ALC4564
AZ
314000000X
Skilled Nursing Facility
Primary
NCI263
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
566292
—
AZ
05
—
618324
—
AZ
Enumeration date
01/04/2007
Last updated
09/08/2021
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