MEDICARE: LITA & AVA INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1689828840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITA & AVA INC.

Provider Business Mailing Address
First Line	:	1250 S WINCHESTER BLVD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-3906
Country	:	US
Telephone Number	:	408-241-3844
Fax Number	:	408-241-6430

Provider Business Practice Location Address
First Line	:	1250 S WINCHESTER BLVD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-3906
Country	:	US
Telephone Number	:	408-241-3844
Fax Number	:	408-241-6430

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JULITA A JAVIER
Credential	:
Telephone Number	:	408-241-3844

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	04/15/2014

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Directions to “LITA & AVA INC. ” Practice Location

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