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General NPI Number Information
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NPI Number | 1437006194
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Entity Type | Organization
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Legal Business Name | AVALON RESIDENTIAL NETWORK, LLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 207 N JEFFERSON ST
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City | SAINT JAMES
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State | MO
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Zip | 65559-1919
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Country | US
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Telephone | 573-647-0927
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 322
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City | SAINT JAMES
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State | MO
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Zip | 65559-0322
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Country | US
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Telephone | 417-413-0429
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | TIMOTHY CARL MCDONALD
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Credential |
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Telephone | 417-413-0429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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