Organization Name: | VILLA ALBA CORPORATION |
NPI Number: | 1679558050 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTINE VILLARAZA TEJADA (ADMINISTRATOR) |
Mailing Address: | 1212 N. Spencer St. Suite 2 Mesa |
State: | AZ US |
Postal Code: | 85203 |
Phone Number: | 4807266553 |
Fax Number: | 4807263329 |
NPI Enumeration Date: | 12/08/2005 |
NPI Last Update Date: | 03/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | HSPC3710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |