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NPI Code Detail

MEDICARE: VILLA MARINA HEALTH AND REHABILITATION CENTER INC

MEDICARE: VILLA MARINA HEALTH AND REHABILITATION CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility3215WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134123573
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLA MARINA HEALTH AND REHABILITATION CENTER INC
Provider Business Mailing Address
First Line : 300 VILLA DRIVE
Second Line :
City : HURLEY
State : WI
Zip : 54534-1523
Country : US
Telephone Number : 715-561-3200
Fax Number : 715-561-5556
Provider Business Practice Location Address
First Line : 35 NORTH 28TH STREET
Second Line :
City : SUPERIOR
State : WI
Zip : 54880-5557
Country : US
Telephone Number : 715-392-3300
Fax Number : 715-392-9660
Authorized Official
Title or Position : PRESIDENT
Name : MR. LAWRENCE J KUTZ
Credential :
Telephone Number : 715-561-3200
Provider Enumeration Date : 06/13/2005
Last Update Date : 09/20/2021

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Directions to “VILLA MARINA HEALTH AND REHABILITATION CENTER INC ” Practice Location

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