Provider Demographics
NPI:1558077479
Name:AVALON HEALTH ESTATES
Entity Type:Organization
Organization Name:AVALON HEALTH ESTATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LILIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIOSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-240-6102
Mailing Address - Street 1:7450 DEL REY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1409
Mailing Address - Country:US
Mailing Address - Phone:702-240-6102
Mailing Address - Fax:702-240-6102
Practice Address - Street 1:7450 DEL REY AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1409
Practice Address - Country:US
Practice Address - Phone:702-240-6102
Practice Address - Fax:702-240-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home