Organization
AVENIDA LIVING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALINA BLANK (MANAGING MEMBER)
(323) 428-4258
Entity
Organization
Contact information
Practice address
2465 AVENIDA DE LAS PLANTAS, THOUSAND OAKS, CA 91360-6619
(805) 557-0010
(805) 557-0020
Mailing address
2465 AVENIDA DE LAS PLANTAS, THOUSAND OAKS, CA 91360-6619
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
550003098
CA
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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