Organization
AVILA RESIDENTIAL SERVICES, INC.
Active
Other names
Avila Residential Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK R AVILA III (EXECUTIVE DIRECTOR/ OWNER)
(276) 238-7100
Entity
Organization
Contact information
Practice address
372 LIVE OAK LN, GALAX, VA 24333-5476
(276) 238-7100
Mailing address
372 LIVE OAK LN, GALAX, VA 24333-5476
(276) 238-7100
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8568-14-035
—
VA
Enumeration date
10/19/2022
Last updated
05/14/2025
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