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Avery Lane
Substance Abuse Rehabilitation Facility in Novato, California
NPI 1801526975

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. You can also correspond with Avery Lane through the mailing address at 505A SAN MARIN DR STE 300, NOVATO, CA - 94945-1321 (mailing address contact number: 415-895-5360).

Location: 2500 Vineyard Rd, Novato, CA, 94945-1321
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
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
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Provider's Legacy Identifiers
Identifier Type State Issuer
210049DP 01 CA DHCS
institution
Provider Business Practice Location Address Details
Address
2500 Vineyard Rd
City
Novato
State
California
Zip
94947-3633
Phone Number
415-895-5360
Fax Number
person
Provider Business Mailing Address Details
Address
2500 Vineyard Rd
City
Novato
State
California
Zip
94947-3633
Phone Number
415-895-5360
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
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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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