Provider Demographics
NPI:1225168917
Name:VILLA SPERANZA
Entity Type:Organization
Organization Name:VILLA SPERANZA
Other - Org Name:VILLA VITTORIA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, LICENSEE
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MBA
Authorized Official - Phone:925-323-7903
Mailing Address - Street 1:2216 CORDOBA WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-5814
Mailing Address - Country:US
Mailing Address - Phone:925-755-5014
Mailing Address - Fax:
Practice Address - Street 1:2216 CORDOBA WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-5814
Practice Address - Country:US
Practice Address - Phone:925-755-5014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA075600358310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility