MEDICARE: ANTELOPE VALLEY HEALING CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	310400000X	Assisted Living Facility
3	3104A0625X	Assisted Living Facility (Mental Illness)
4	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
5	313M00000X	Nursing Facility/Intermediate Care Facility
6	3140N1450X	Pediatric Skilled Nursing Facility
7	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1659222966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTELOPE VALLEY HEALING CENTER

Provider Business Mailing Address
First Line	:	38700 5TH ST W STE G
Second Line	:
City	:	PALMDALE
State	:	CA
Zip	:	93551-3996
Country	:	US
Telephone Number	:	661-206-7900
Fax Number	:	661-209-3750

Provider Business Practice Location Address
First Line	:	1759 WINDERMERE DR
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-5319
Country	:	US
Telephone Number	:	661-206-7900
Fax Number	:	661-209-3750

Authorized Official
Title or Position	:	CFO
Name	:	MR. KENNY ARYA
Credential	:
Telephone Number	:	661-538-1435

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “ANTELOPE VALLEY HEALING CENTER ” Practice Location

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