Provider Demographics
NPI:1033437769
Name:AVANTE AT THOMASVILLE, INC.
Entity Type:Organization
Organization Name:AVANTE AT THOMASVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DICKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-987-7180
Mailing Address - Street 1:4000 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 540 NORTH
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6751
Mailing Address - Country:US
Mailing Address - Phone:954-987-7180
Mailing Address - Fax:954-989-5287
Practice Address - Street 1:1028 BLAIR ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-4359
Practice Address - Country:US
Practice Address - Phone:954-987-7180
Practice Address - Fax:954-989-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility