Healthcare Provider Details

I. General information

NPI: 1972437150
Provider Name (Legal Business Name): THE VILLA HOUSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 GOLDE ST
JOHNSTOWN PA
15902-2042
US

IV. Provider business mailing address

300 GOLDE ST
JOHNSTOWN PA
15902-2042
US

V. Phone/Fax

Practice location:
  • Phone: 814-507-2349
  • Fax:
Mailing address:
  • Phone: 814-507-2349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DAMITA N MORRIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 814-521-2713