St. John's Villa

NPI #1174691927 in Carrollton, Ohio

Provider Information

NPI Number: 1174691927
Entity Type: Organization
Organization Name: St. John's Villa
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 1, 2006
Last Updated: Jun 16, 2008

Practice Location

Address: 701 CREST ST NW
City: Carrollton
State: Ohio
ZIP Code: 44615-8425
Phone: (330) 627-9789

Authorized Official

Name: DAVID L. LYON
Title: PRESIDENT
Phone: (330) 627-9789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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