Provider Demographics
NPI:1154157824
Name:THE VILLAS AT SAINT THERESE
Entity type:Organization
Organization Name:THE VILLAS AT SAINT THERESE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:RAI
Authorized Official - Last Name:FAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-751-5700
Mailing Address - Street 1:25 NOE BIXBY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1411
Mailing Address - Country:US
Mailing Address - Phone:614-751-5700
Mailing Address - Fax:
Practice Address - Street 1:25 NOE BIXBY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1411
Practice Address - Country:US
Practice Address - Phone:614-751-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility