| NPI | 1285890095 |
|---|---|
| Doing Business As | VILLA MARIA AT LIGHT STREET |
| Doing Business As | VILLA MARIA AT LIGHT STREET PRP |
| Entity Type | Organization |
| Authorized Contact | GLORIA REEVES A/R And Billing Manager 667-600-2249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2020-01-03 |