Organization
VILLA HOUSE, INC
Active
Other names
Villa House, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN DODSON (EXEC. DIRECTOR)
(618) 983-8513
Entity
Organization
Contact information
Practice address
1112 WASHINGTON AVE, JOHNSTON CITY, IL 62951-1536
(618) 983-8513
(618) 983-8513
Mailing address
1112 WASHINGTON AVE, P O BOX 299, JOHNSTON CITY, IL 62951-1536
(618) 983-8513
(618) 983-8513
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
94S200
IL
Other
Enumeration date
04/10/2007
Last updated
08/22/2020
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