Provider Demographics
NPI:1558135939
Name:ANAVERDES VILLA, INC
Entity Type:Organization
Organization Name:ANAVERDES VILLA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-526-7000
Mailing Address - Street 1:37335 PAINTBRUSH DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-6173
Mailing Address - Country:US
Mailing Address - Phone:661-526-7000
Mailing Address - Fax:888-878-6958
Practice Address - Street 1:37335 PAINTBRUSH DR
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-6173
Practice Address - Country:US
Practice Address - Phone:661-526-7000
Practice Address - Fax:888-878-6958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities