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General NPI Number Information
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NPI Number | 1881102408
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Entity Type | Organization
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Legal Business Name | AVA FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 3455 PEACHTREE RD NE STE 500
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City | ATLANTA
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State | GA
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Zip | 30326-3236
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Country | US
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Telephone | 404-354-4388
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Fax |
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Provider Business Mailing Address
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Address Line | 3455 PEACHTREE RD NE STE 500A
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City | ATLANTA
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State | GA
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Zip | 30326-3254
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Country | US
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Telephone | 404-354-4388
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DWAYNE GRAY
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Credential |
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Telephone | 919-454-1672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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