# AV CONGREGATE LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306245105
- **Authorized official:** JERRICO REYES (PRESIDENT)
- **Authorized official phone:** (661) 943-1262

## Contact information

- **Practice address:** 4144 VAHAN CT, LANCASTER, CA 93536-6838
- **Practice address phone:** (661) 943-1262
- **Mailing address:** 4144 VAHAN COURT, LANCASTER, CA 93536
- **Mailing address phone:** (661) 943-1262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2014
- **Last updated:** 08/18/2014