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General NPI Number Information
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NPI Number | 1922853324
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Entity Type | Organization
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Legal Business Name | VENTURA HARBOR RESTAURANT ASSOCIATES INC
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 1510 ANCHORS WAY DR
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City | VENTURA
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State | CA
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Zip | 93001-6282
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Country | US
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Telephone | 805-612-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N WESTLAKE BLVD STE 100
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3771
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Country | US
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Telephone | 805-612-0202
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS, CFO
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Name | MR. ORESTIS SIMOS
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Credential |
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Telephone | 805-612-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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