MEDICARE: AZARIA VILLAGE GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871475228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZARIA VILLAGE GROUP INC

Provider Business Mailing Address
First Line	:	7738B MADISON BLVD STE 204
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-3661
Country	:	US
Telephone Number	:	844-292-7428
Fax Number	:

Provider Business Practice Location Address
First Line	:	7738B MADISON BLVD STE 204
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-3661
Country	:	US
Telephone Number	:	844-292-7428
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ROSALYN LAMAR
Credential	:	PHD
Telephone Number	:	470-480-6058

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	12/29/2025

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