Organization
GREEN PARADISE ADULT HOME CARE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON SCOTT AVERY (OWNER)
(760) 503-1390
Entity
Organization
Contact information
Practice address
19801 TOMAHAWK RD, APPLE VALLEY, CA 92307-5013
(760) 503-1390
(760) 503-1390
Mailing address
19801 TOMAHAWK RD, APPLE VALLEY, CA 92307-5013
(760) 503-1390
(760) 503-1390
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
336427614
CA
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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