MEDICARE: AURA RETREAT ASSISTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1457235541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURA RETREAT ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	9314 TAMPA AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2744
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9314 TAMPA AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2744
Country	:	US
Telephone Number	:	657-200-9124
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DOMINIQUE L DUNN
Credential	:	FNP-C, PMHNP-BC
Telephone Number	:	657-200-9124

Provider Enumeration Date	:	08/02/2025
Last Update Date	:	08/02/2025

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