Provider Demographics
NPI:1447556378
Name:RELIANCE
Entity type:Organization
Organization Name:RELIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AVELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:661-424-1169
Mailing Address - Street 1:18333 DOLAN WAY
Mailing Address - Street 2:210
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-5424
Mailing Address - Country:US
Mailing Address - Phone:661-424-1169
Mailing Address - Fax:661-424-1224
Practice Address - Street 1:18333 DOLAN WAY
Practice Address - Street 2:210
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-5424
Practice Address - Country:US
Practice Address - Phone:661-424-1169
Practice Address - Fax:661-424-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001369251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health