MEDICARE: VIOLA VENTURES, 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
2	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1104541580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIOLA VENTURES, LLC

Provider Business Mailing Address
First Line	:	1813 GARNER RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-3923
Country	:	US
Telephone Number	:	919-532-9707
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 PAMLICO ST
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889-3821
Country	:	US
Telephone Number	:	252-946-2481
Fax Number	:	252-946-6356

Authorized Official
Title or Position	:	CEO
Name	:	BRITTANY S NWANKWO
Credential	:
Telephone Number	:	919-532-9707

Provider Enumeration Date	:	10/07/2022
Last Update Date	:	11/15/2022

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Directions to “VIOLA VENTURES, LLC ” Practice Location

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