Avery Lane is a Substance Abuse Rehabilitation Facility based in Novato, CA. Avery Lane practices in Novato, CA. The NPI Number for Avery Lane is 1801526975 and holds a License No. (California).
The current practice location address for Avery Lane is 2500 Vineyard Rd, Novato, CA and can be reached out via phone at 415-895-5360.
Location: 2500 Vineyard Rd, Novato, CA, 94945-1321
Provider Profile Details
NPI Number
1801526975
Provider Name
Avery Lane
Credential
Provider Entity Type
Organization
Address
2500 Vineyard Rd, Novato, CA, 94945-1321
Phone Number
415-895-5360
Fax Number
Provider Enumeration Date
06/13/2022
Last Update Date
03/13/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210049DP | 01 | CA | DHCS |
Provider Business Practice Location Address Details
Address
2500 Vineyard Rd
City
State
Zip
94947-3633
Phone Number
415-895-5360
Fax Number
Provider Business Mailing Address Details
Address
2500 Vineyard Rd
City
State
Zip
94947-3633
Phone Number
415-895-5360
Fax Number
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
License No.
()
Definition
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.
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