Provider Demographics
NPI:1669334975
Name:AVERETTE COMFORT RESIDENCY LLC
Entity type:Organization
Organization Name:AVERETTE COMFORT RESIDENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEYSHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-692-6347
Mailing Address - Street 1:63 DESERT WOOD CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-6215
Mailing Address - Country:US
Mailing Address - Phone:916-692-6347
Mailing Address - Fax:
Practice Address - Street 1:63 DESERT WOOD CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-6215
Practice Address - Country:US
Practice Address - Phone:916-692-6347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility