Provider Demographics
NPI:1366867087
Name:AVALON HOMECARE, INC
Entity Type:Organization
Organization Name:AVALON HOMECARE, INC
Other - Org Name:AVALON HOMECARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OPERATIONS/CARE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:HOLLY
Authorized Official - Last Name:MARSOLAIS
Authorized Official - Suffix:
Authorized Official - Credentials:CHCM
Authorized Official - Phone:760-730-3955
Mailing Address - Street 1:390 OAK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2966
Mailing Address - Country:US
Mailing Address - Phone:760-730-3955
Mailing Address - Fax:760-730-3977
Practice Address - Street 1:390 OAK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2966
Practice Address - Country:US
Practice Address - Phone:760-730-3955
Practice Address - Fax:760-730-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care