MEDICARE: LAS VILLAS DEL NORTE OPERATIONS, 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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1326378472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VILLAS DEL NORTE OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	1335 LAS VILLAS WAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-1921
Country	:	US
Telephone Number	:	760-741-1047
Fax Number	:

Provider Business Practice Location Address
First Line	:	1335 LAS VILLAS WAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-1921
Country	:	US
Telephone Number	:	760-741-1047
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ROBIN L BARBER
Credential	:
Telephone Number	:	502-753-6004

Provider Enumeration Date	:	01/12/2010
Last Update Date	:	11/14/2013

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