Provider Demographics
NPI:1225310212
Name:AVN ENTERPRISES INC.
Entity Type:Organization
Organization Name:AVN ENTERPRISES INC.
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-734-1111
Mailing Address - Street 1:31025 CENTER RIDGE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5029
Mailing Address - Country:US
Mailing Address - Phone:440-734-1111
Mailing Address - Fax:440-734-1114
Practice Address - Street 1:31025 CENTER RIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5029
Practice Address - Country:US
Practice Address - Phone:440-734-1111
Practice Address - Fax:440-734-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2769713Medicaid