# STELLAVILLA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063541753
- **Authorized official:** MRS. CAROL DELORES SHAW (DIRECTOR)
- **Authorized official phone:** (770) 593-2539

## Contact information

- **Practice address:** 3848 CAIN MILL DR, LITHONIA, GA 30038-3868
- **Practice address phone:** (770) 593-2539
- **Practice address fax:** (770) 593-0691
- **Mailing address:** 3848 CAIN MILL DR, LITHONIA, GA 30038-3868
- **Mailing address phone:** (770) 593-2539
- **Mailing address fax:** (770) 593-0691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 08/22/2020