AVENIDA LIVING HOME INC. NPI 1619336740

NPI Information

AVENIDA LIVING HOME, INC. is a residential treatment facility physical disabilities in Thousand Oaks, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. AVENIDA LIVING HOME, INC. NPI is 1619336740. The provider is registered as an organization entity type.

The provider's business location address is:

2465 AVENIDA DE LAS PLANTAS
THOUSAND OAKS, CA
ZIP 91360-619
Phone: (805) 557-0010
Fax: (805) 557-0020

The provider's authorized official is Galina Blank .
The authorized official title is Managing Member and has the following contact phone number (323) 428-4258.

The CLIA number assigned to this NPI record is 05D2110188 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2016 and was last updated on 2/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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