Avery Lane
Organization Active NPI Substance Abuse Rehabilitation Facility · Novato, CA
NPI 1275178014 · NPPES record last updated Nov 15, 2019
Key facts
- NPI
- 1275178014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- AVERY LANE
- Practice address
- 685 Atherton Ave
Novato, CA 94945-2617 - Phone
- (415) 408-3480
- Fax
- (415) 895-5297
- NPI assigned
- Nov 15, 2019
- Organization subpart
- No
Authorized official
- Name
- Camille Hildebrand
- Title
- Ceo
- Phone
- (415) 686-6127
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Avery Lane
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Yes |
Addresses
Primary practice location
685 Atherton Ave
Novato, CA 94945-2617
Mailing address
505 San Marin Dr Ste A300
Novato, CA 94945-1351
Phone (415) 895-5360
Other providers in Novato, CA
- Julia Aube
- Audiology Associates
- Kevin Austin
- Nathali Austin
- Paola Avalos
- Avery Lane
- Avery Lane
- Avery Lane
- Avery Lane
- Tajus Anand Ayyar
All providers in Novato, CA · Substance Abuse Rehabilitation Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.