Provider Demographics
NPI:1346965399
Name:AVPA LLC
Entity Type:Organization
Organization Name:AVPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:TAPANG
Authorized Official - Last Name:DITULLIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-523-8956
Mailing Address - Street 1:4016 GRAND AVE STE A-1062
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5491
Mailing Address - Country:US
Mailing Address - Phone:626-523-8956
Mailing Address - Fax:626-657-2778
Practice Address - Street 1:1875 BARTON RD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5308
Practice Address - Country:US
Practice Address - Phone:909-793-1382
Practice Address - Fax:909-308-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility