MEDICARE: VICTORIAN VILLA ASSISTED LIVING LLC

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
1	310400000X	Assisted Living Facility	AM380392463	MI

General Provider Information

NPI Number	:	1386124550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORIAN VILLA ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	5585 BROOKLYN RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-8570
Country	:	US
Telephone Number	:	517-764-4163
Fax Number	:

Provider Business Practice Location Address
First Line	:	5585 BROOKLYN RD SOUTH
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-8570
Country	:	US
Telephone Number	:	517-764-4163
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LINDA M WEST
Credential	:	RN
Telephone Number	:	517-315-1725

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	08/17/2018

Similar Medicare Providers

1215653399 — AMANDA MCVEY
Practice Location Address:

330 W MICHIGAN AVE
JACKSON, MI
49201-2121

Practice Phone: 517-706-7994
Practice Fax:

1326078866 — W. A. FOOTE MEMORIAL HOSPITAL, INC.
Practice Location Address:

205 N EAST AVE
JACKSON, MI
49201-1753

Practice Phone: 517-788-4800
Practice Fax:

1760437826 — W. A. FOOTE MEMORIAL HOSPITAL, INC
Practice Location Address:

205 N EAST AVE
JACKSON, MI
49201-1753

Practice Phone: 517-788-4800
Practice Fax:

1093657074 — DR. PRANALI SUDHIR KULKARNI DO
Practice Location Address:

205 N EAST AVE
JACKSON, MI
49201-1753

Practice Phone: 734-306-8614
Practice Fax:

1902748775 — NINA NICOLE MENDOZA SUAN MD
Practice Location Address:

205 N EAST AVE
JACKSON, MI
49201-1753

Practice Phone: 517-205-4800
Practice Fax:

1114869864 — MS. ANUPRIYA LILHORI M.D
Practice Location Address:

205, N EAST AVE HENRY FORD JACKSON HOSPITAL
JACKSON, MI
49201

Practice Phone: 517-207-7116
Practice Fax: 517-205-7050

Directions to “VICTORIAN VILLA ASSISTED LIVING LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.