| NPI | 1528201498 |
|---|---|
| Doing Business As | AVALON RANCH |
| Entity Type | Organization |
| Authorized Contact | PEGGY LOCKE Claims Administrator 805-488-5159 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 190612AP) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2009-04-08 |