Provider Demographics
NPI:1033694039
Name:AVALON HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:AVALON HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:DON
Authorized Official - Phone:832-350-2573
Mailing Address - Street 1:9898 BISSONNET ST STE 670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8059
Mailing Address - Country:US
Mailing Address - Phone:832-350-2573
Mailing Address - Fax:
Practice Address - Street 1:9898 BISSONNET ST STE 670
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8059
Practice Address - Country:US
Practice Address - Phone:832-350-2573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based