Healthcare Provider Details

I. General information

NPI: 1265610307
Provider Name (Legal Business Name): AVENIR VENTURES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 ATLANTIC PL STE B-50
SOUTH PORTLAND ME
04106-2316
US

IV. Provider business mailing address

3854 AMERICAN WAY STE A
BATON ROUGE LA
70816-4897
US

V. Phone/Fax

Practice location:
  • Phone: 877-202-2869
  • Fax: 855-713-2273
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS MIGLICCO
Title or Position: VP TAX
Credential:
Phone: 225-299-3803