- Enrollment id
- O20160503001355
- Enrollment state
- AZ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952767774
- Multiple npi flag
- N
- Ccn
- 035291
- Associate id
- 4486953056
- Organization name
- CENTER AT VAL VISTA LLC
- Doing business as name
- THE CENTER AT VAL VISTA
- Incorporation date
- 2015-03-10
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- THE CENTER AT VAL VISTA, LLC
- Affiliation entity name
- VERITAS MANAGEMENT GROUP
- Affiliation entity id
- 545
- Address line 1
- 3744 S ROME ST
- City
- GILBERT
- State
- AZ
- Zip code
- 852977350