Provider Demographics
NPI:1568248821
Name:AVANT HOME CARE LLC
Entity Type:Organization
Organization Name:AVANT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONDREA
Authorized Official - Middle Name:SHAVONE
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-698-6968
Mailing Address - Street 1:2347 LONGMONT DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2083
Mailing Address - Country:US
Mailing Address - Phone:678-698-6968
Mailing Address - Fax:
Practice Address - Street 1:2347 LONGMONT DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2083
Practice Address - Country:US
Practice Address - Phone:678-698-6968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care