Healthcare Provider Details

I. General information

NPI: 1164741765
Provider Name (Legal Business Name): YOFILI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 06/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1774 CABALLERO ST
SIMI VALLEY CA
93065-4814
US

IV. Provider business mailing address

1774 CABALLERO ST
SIMI VALLEY CA
93065-4814
US

V. Phone/Fax

Practice location:
  • Phone: 805-285-5440
  • Fax: 805-285-5443
Mailing address:
  • Phone: 805-285-5440
  • Fax: 805-285-5443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ROY L MARTIN II
Title or Position: PRESIDENT
Credential:
Phone: 805-285-5440