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General NPI Number Information
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NPI Number | 1992125348
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Entity Type | Organization
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Legal Business Name | AVANT-GARDE CARE AGENCY LLC
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 9459 LANHAM SEVERN RD
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City | LANHAM
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State | MD
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Zip | 20706-2641
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Country | US
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Telephone | 240-770-5673
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Fax | 240-770-3701
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Provider Business Mailing Address
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Address Line | 9459 LANHAM SEVERN RD
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City | LANHAM
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State | MD
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Zip | 20706-2641
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Country | US
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Telephone | 240-770-5673
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Fax | 240-770-3701
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MS. AMARA UZOMAH
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Credential | RN
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Telephone | 240-770-5673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R3558
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License Number State | MD
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