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General NPI Number Information
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NPI Number | 1962106930
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Entity Type | Organization
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Legal Business Name | AVAD CARE LLC
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 6426 MARKET ST
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City | BOARDMAN
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State | OH
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Zip | 44512-3434
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Country | US
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Telephone | 330-687-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 302 RETORT DR
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City | EDINBURG
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State | PA
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Zip | 16116-2020
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Country | US
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Telephone | 330-687-4750
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW DAWSON
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Credential |
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Telephone | 330-687-4750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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