| NPI | 1356838700 |
|---|---|
| Doing Business As | VILLA MARIA SUD- FALLSTAFF LEVEL 1 |
| Entity Type | Organization |
| Authorized Contact | GLORIA OVERSMITH Billing Manager 667-600-2249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2020-01-03 |