Healthcare Provider Details

I. General information

NPI: 1013976513
Provider Name (Legal Business Name): AVALON CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 HARRIS HILL RD
WILLIAMSVILLE NY
14221-7407
US

IV. Provider business mailing address

346 HARRIS HILL RD
WILLIAMSVILLE NY
14221-7407
US

V. Phone/Fax

Practice location:
  • Phone: 716-839-0999
  • Fax: 716-839-2058
Mailing address:
  • Phone: 716-839-0999
  • Fax: 716-839-2058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9255320A
License Number StateNY

VIII. Authorized Official

Name: MR. ARTHUR BOESE
Title or Position: CEO
Credential:
Phone: 716-839-0999