Organization
VILLA CREST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY WILLIAM OTTO NHA (ADMINISTRATOR/CONSULTANT)
(814) 288-1418
Entity
Organization
Contact information
Practice address
1451 FRANKSTOWN RD, JOHNSTOWN, PA 15902-1318
(814) 288-1418
(814) 288-1525
Mailing address
1451 FRANKSTOWN RD, JOHNSTOWN, PA 15902-1318
(814) 288-1418
(814) 288-1525
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/13/2018
Last updated
03/12/2019
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