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Organization
VILLA COURT LLC
Active
Organization
VILLA COURT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS RUSS (OWNER)
(239) 656-2887
Entity
Organization
Contact information
Practice address
1992 QUEEN ST, NORTH FORT MYERS, FL 33917-3942
(239) 656-2887
Mailing address
1992 QUEEN ST, NORTH FORT MYERS, FL 33917-3942
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11807
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002649500
—
FL
Enumeration date
03/29/2013
Last updated
03/29/2013
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