Provider Demographics
NPI:1821576216
Name:AURORA VISTA DEL MAR, LLC
Entity Type:Organization
Organization Name:AURORA VISTA DEL MAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:HANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-905-5091
Mailing Address - Street 1:801 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-1411
Mailing Address - Country:US
Mailing Address - Phone:805-653-6434
Mailing Address - Fax:
Practice Address - Street 1:801 SENECA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-1411
Practice Address - Country:US
Practice Address - Phone:805-653-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AURORA VISTA DEL MAR, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital