Provider Demographics
NPI:1376315291
Name:APPLE VALLEY RETIREMENT INC
Entity Type:Organization
Organization Name:APPLE VALLEY RETIREMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:VASIL
Authorized Official - Last Name:KARKALETSIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-240-2600
Mailing Address - Street 1:12994 RINCON RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-6284
Mailing Address - Country:US
Mailing Address - Phone:760-240-2600
Mailing Address - Fax:
Practice Address - Street 1:12994 RINCON RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-6284
Practice Address - Country:US
Practice Address - Phone:760-240-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility