Organization
ADULT HOME VILLA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESMERALDA MANUKONDA (ADMINISTRATOR)
(727) 321-7446
Entity
Organization
Contact information
Practice address
4760 8TH AVE S, ST PETERSBURG, FL 33711-1810
(727) 321-7446
Mailing address
4760 8TH AVE S, ST PETERSBURG, FL 33711-1810
(727) 321-7446
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL5408
FL
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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