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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