Healthcare Provider Details

I. General information

NPI: 1821576216
Provider Name (Legal Business Name): AURORA VISTA DEL MAR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SENECA ST
VENTURA CA
93001-1411
US

IV. Provider business mailing address

801 SENECA ST
VENTURA CA
93001-1411
US

V. Phone/Fax

Practice location:
  • Phone: 805-653-6434
  • Fax:
Mailing address:
  • Phone: 805-653-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: HANA ATTAR
Title or Position: AVP
Credential:
Phone: 248-905-5091