AVERY LANE (NPI# 1275178014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275178014 |
| Entity Type | Organization |
| Organization Name | AVERY LANE |
| Practice Address |
685 Atherton Ave Novato CA 94945-2617 |
| Mailing Address |
505 San Marin Dr Ste A300 Novato CA 94945-1351 |
| Practice Telephone | 4154083480 |
| Practice Fax Number | 4158955297 |
| Mailing Telephone | 4158955360 |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-15 |
| Authorized Official Name | CAMILLE HILDEBRAND (CEO) |
| Authorized Official Telephone | 4156866127 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922552496 | Avery Lane | Clinic/Center | 505 San Marin Dr, Suite 300, Novato, CA 94945-1309 | 2016-08-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | AVERY LANE COMMUNITY ASSOCIATION | 8079 Avery Ln, Sedro Woolley, WA 98284-8707 |
| Oregon Corporations, Companies and Business Names | AVERY LANE DESIGNS | 513 Nw Witham Dr, Corvallis, OR 97330 |
| Washington State Corporations | AVERY LANE FARMS LLC | 64405 E 99 Pr Se, Benton City, WA 99320-8529 |
| North Carolina Corporations | Avery Lane Photography LLC | 1006 Hampton Court, Leland, NC 28451 |
| Connecticut Business Registrations | AVERY LANE, LLC | 35 Huntington Street, New London, CT 06320 |
| Street Address |
685 ATHERTON AVE |
| City | NOVATO |
| State | CA |
| Zip Code | 94945-2617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124639943 | Joseph Francis Bielefeld | Nurse Practitioner | Marinhealth, 75 Rowland Way, #230, Novato, CA 94945 | 2020-08-14 |
| 1255835203 | California Orthopedics & Spine Inc | Physical Therapist | 7100 Redwood Boulevard, Suite 200, Novato, CA 94945 | 2018-03-22 |
| 1932601648 | Dawn Cheree Holiday-bruner | Marriage & Family Therapist | 6965 Redwood Blvd, Novato, CA 94945 | 2018-03-08 |
| 1558789545 | Kristi Marie Hudson | Marriage & Family Therapist | 7250 Redwood Blvd., Suite 300, Novato, CA 94945 | 2014-04-07 |
| 1467738484 | Andrea E Lieberstein | Dietitian, Registered | 800 De Long Avenue, Suite 100, Novato, CA 94945 | 2011-10-24 |
| 1992954473 | Elizabeth Taryn Clark | Marriage & Family Therapist | 7250 Redwood Blvd Ste 320, Novato, CA 94945 | 2008-09-09 |
| 1255508453 | Renew Physical Therapy PC | Clinic/Center | 1427 Grant Ave, Novato, CA 94945 | 2008-05-15 |
| 1407032824 | Richard P. Knudsen | Pediatrics | 100 Rowland Way, Suite 300, Pulmonary and Sleep Associates of Marin, Novato, CA 94945 | 2008-01-16 |
| 1528250735 | Susan Jean Arndt | Counselor | 505-a San Marin Drive Suite 150, Novato, CA 94945 | 2007-08-11 |
| 1588871735 | Margaret Carol Pappas | Registered Nurse | 1025 Fifth Street, Novato, CA 94945 | 2007-05-17 |
| Find all providers in zip 94945 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518312529 | Living At Reflections, LLC | Substance Abuse Rehabilitation Facility | 10 Lockton Ln, Novato, CA 94945-2727 | 2016-04-27 |
| 1356715098 | Jesse Jones | Substance Abuse Rehabilitation Facility | 530 Loleta Ln, Novato, CA 94947-5210 | 2015-11-18 |
| 1912375254 | Eric Joseph Peters Sr. | Substance Abuse Rehabilitation Facility | 629 Wilson Ave, Novato, CA 94947-3823 | 2015-09-03 |
| 1174862064 | Living At Reflections LLC | Substance Abuse Rehabilitation Facility | 1191 Simmons Ln, Novato, CA 94945-1735 | 2013-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.