Provider Demographics
NPI:1285830901
Name:AUNDREY'S RESIDENTIAL CARE, INC.
Entity Type:Organization
Organization Name:AUNDREY'S RESIDENTIAL CARE, INC.
Other - Org Name:PVM PROPERTIE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-585-7956
Mailing Address - Street 1:8335 WINNETKA AVENUE #626
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306
Mailing Address - Country:US
Mailing Address - Phone:818-585-7956
Mailing Address - Fax:
Practice Address - Street 1:5740 OSTROM AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1406
Practice Address - Country:US
Practice Address - Phone:818-758-0196
Practice Address - Fax:818-758-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home