Healthcare Provider Details

I. General information

NPI: 1427967595
Provider Name (Legal Business Name): AVILA GROUP HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7226 NOVA SCOTIA DR
PORT RICHEY FL
34668-5733
US

IV. Provider business mailing address

7310 ROBSTOWN DR
PORT RICHEY FL
34668-3974
US

V. Phone/Fax

Practice location:
  • Phone: 813-562-6855
  • Fax:
Mailing address:
  • Phone: 813-562-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MARIA AVILA
Title or Position: OWNER/CEO
Credential:
Phone: 813-562-6855