| NPI | 1346363553 |
|---|---|
| Doing Business As | VILLA HOUSE, INC |
| Entity Type | Organization |
| Authorized Contact | ROBIN DODSON Exec. Director 618-983-8513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 94S200) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |