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Organization

ANTHONYS VILLA RESIDENTIAL SERVICES L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANTHONY CAMPBELL (CEO)
(567) 290-2658
Entity
Organization

Contact information

Practice address
1031 PIERCE ST STE 306, SANDUSKY, OH 44870-4669
(567) 290-2658
Mailing address
PO BOX 337, SANDUSKY, OH 44871-0337
(567) 290-2658

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
163WC0400X
Case Management Registered Nurse
171400000X
Health & Wellness Coach
171M00000X
Case Manager/Care Coordinator
172A00000X
Driver
251S00000X
Community/Behavioral Health Agency
253J00000X
Foster Care Agency
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
385H00000X
Respite Care
Primary
405300000X
Prevention Professional

Other

Enumeration date
03/09/2023
Last updated
05/21/2023
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