Organization
AVISTA HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GODFREY NWOGENE (DIRECTOR)
(951) 577-4360
Entity
Organization
Contact information
Practice address
1453 GOLDENEAGLE DR, CORONA, CA 92879-8891
(951) 577-4360
Mailing address
414 W GRAND BLVD UNIT 372, CORONA, CA 92878-7218
(951) 577-4360
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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