Organization
VILLA HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE R PETERSON (ADMINISTRATOR)
(218) 644-3331
Entity
Organization
Contact information
Practice address
1220 VILLA COURT DR, CROMWELL, MN 55726-4503
(218) 644-3331
(218) 644-3505
Mailing address
1220 VILLA COURT DRIVE, CROMWELL, MN 55726
(218) 644-3331
(218) 644-3505
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
352691
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
352691
MINNESOTA DEPARTMENT OF HEALTH CLASS A HOME CARE LICENSE
MN
Enumeration date
08/24/2011
Last updated
08/24/2011
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