Healthcare Provider Details

I. General information

NPI: 1790192359
Provider Name (Legal Business Name): AMANDA VILLANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W EDISON AVE
NEW CASTLE PA
16101-2174
US

IV. Provider business mailing address

222 W EDISON AVE
NEW CASTLE PA
16101-2174
US

V. Phone/Fax

Practice location:
  • Phone: 724-652-6340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberTEI000762
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: