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General NPI Number Information
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NPI Number | 1376656512
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Entity Type | Organization
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Legal Business Name | PIERZ VILLA, INC.
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 119 FAUST ST
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City | PIERZ
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State | MN
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Zip | 56364-9540
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Country | US
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Telephone | 320-468-6405
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Fax | 320-468-0088
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Provider Business Mailing Address
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Address Line | 119 FAUST ST PO BOX 397
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City | PIERZ
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State | MN
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Zip | 56364-9540
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Country | US
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Telephone | 320-468-6405
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Fax | 320-468-0088
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES BENEDICT BIRCHEM
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Credential |
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Telephone | 320-631-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 331139
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License Number State | MN
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