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Avery Lane
Mental Illness Community Based Residential Treatment Facility in Novato, California
NPI 1306568373

Avery Lane is a Mental Illness Community Based Residential Treatment Facility based in Novato, CA. Avery Lane practices in Novato, CA. The NPI Number for Avery Lane is 1306568373 and holds a License No. (California).

The current practice location address for Avery Lane is 200 Atherton Ave, Novato, CA and can be reached out via phone at 415-895-5360 and via fax at 415-895-5053.

Location: 200 Atherton Ave, Novato, CA, 94945-1321
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306568373
Provider Name
Avery Lane
Credential
Provider Entity Type
Organization
Address
200 Atherton Ave, Novato, CA, 94945-1321
Phone Number
415-895-5360
Fax Number
415-895-5053
Provider Enumeration Date
09/15/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
210049AP 01 CA DHCS
institution
Provider Business Practice Location Address Details
Address
200 Atherton Ave
City
Novato
State
California
Zip
94945-3458
Phone Number
415-895-5360
Fax Number
415-895-5053
person
Provider Business Mailing Address Details
Address
200 Atherton Ave
City
Novato
State
California
Zip
94945-3458
Phone Number
415-895-5360
Fax Number
415-895-5053
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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