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Organization
COUNTRY VILLA SERVICE CORP.
Active
Organization
COUNTRY VILLA SERVICE CORP.
Active
Other names
COUNTRY VILLA HEALTH SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL PETTERSON (VICE PRESIDENT - CAMS)
(310) 574-3733
Entity
Organization
Contact information
Practice address
5120 W GOLDLEAF CIR STE 400, LOS ANGELES, CA 90056-1297
(310) 574-3733
Mailing address
5120 W GOLDLEAF CIR STE 400, LOS ANGELES, CA 90056-1297
(310) 574-3733
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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