Johnson Home Assisted Living, Inc.

LBN: Villa Grove Assisted Living
Johnson Home Assisted Living, Inc. is an health care organization with primary practice located at 403 W 13Th St , Pueblo CO 81003-2748. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living, Mental Illness, which is considered as the primary health care specialty. Villa Grove Assisted Living can be contacted via phone (719) 543-0305, or through Spicola, Paul via phone (719) 369-4567.

Contact Information

Primary practice address
403 W 13Th St Pueblo CO 81003-2748
Phone: (719) 543-0305
Fax: (719) 562-9684
Website:
Map and Directions
Authorized official contact:
Name: Spicola, Paul
Phone: (719) 369-4567

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living, Mental Illness 3104A0625X 230602 Colorado

Profile Details

NPI number 1316302664
LBN Legal business name Villa Grove Assisted Living
DBA Doing business as Johnson Home Assisted Living, Inc.
Authorized official Spicola, Paul
Entity Organization
Organization subpart 1 No
Enumeration date Dec 30th, 2015
Last updated Dec 30th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316302664 NPPES
Colorado MEDICAID 26420554

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