Healthcare Provider Details

I. General information

NPI: 1801054895
Provider Name (Legal Business Name): AUNDREYS RESIDENTIAL CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8335 WINNETKA AVE # 162
WINNETKA CA
91306-1630
US

IV. Provider business mailing address

5740 OSTROM AVE
ENCINO CA
91316-1406
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number197607102
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: PAULETTE MOSES
Title or Position: CEO/ ADMINISTRATOR
Credential: B.S.,
Phone: 818-585-7956