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General NPI Number Information
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NPI Number | 1922893320
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Entity Type | Organization
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Legal Business Name | DYLETTE FAMILY FOUNDATION
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1946 RIDGEGATE LN APT L
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City | SIMI VALLEY
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State | CA
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Zip | 93065-2959
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Country | US
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Telephone | 805-328-0990
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 940531
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City | SIMI VALLEY
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State | CA
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Zip | 93094-0531
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Country | US
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Telephone | 805-328-0980
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | HOWAR DAVIS
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Credential |
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Telephone | 805-328-0980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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