NPI 1346363553

Villa House, INC

Organisation Exclusive Provider Organization Johnston City, IL

Practice location

Address: 1112 Washington Ave, Johnston City, IL 62951-1536
Phone: (618) 983-8513
Fax: (618) 983-8513
Mailing address: 1112 Washington Ave P O Box 299, Johnston City, IL 62951-1536

Authorised official

Name: Robin Dodson
Title: Exec. Director
Phone: (618) 983-8513

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 94S200 (IL)

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Registry record

NPI: 1346363553
Entity type: Organization
NPI issued: 10 Apr 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.