Organization
VILLA VISTA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE R PETERSON (ADMINISTRATOR)
(218) 644-3331
Entity
Organization
Contact information
Practice address
1197 VILLA VISTA CIRCLE, CROMWELL, MN 55726-0098
(218) 644-3331
(218) 644-3505
Mailing address
1197 VILLA VISTA CIRCLE, CROMWELL, MN 55726-0098
(218) 644-3331
(218) 644-3505
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
330912
MN
Other
Enumeration date
12/29/2005
Last updated
08/22/2020
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