| NPI | 1982697397 |
|---|---|
| Doing Business As | HENRY CLAY VILLA |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS K MITTLEIDER President 770-619-0866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: PA 060602) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-09-24 |