Healthcare Provider Details

I. General information

NPI: 1285830901
Provider Name (Legal Business Name): AUNDREY'S RESIDENTIAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 OSTROM AVE
ENCINO CA
91316-1406
US

IV. Provider business mailing address

8335 WINNETKA AVENUE #626
WINNETKA CA
91306
US

V. Phone/Fax

Practice location:
  • Phone: 818-758-0196
  • Fax: 818-758-0358
Mailing address:
  • Phone: 818-585-7956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. PAULETTE MOSES
Title or Position: CEO
Credential:
Phone: 818-585-7956