Provider Demographics
NPI:1619630977
Name:AVANZA BEHAVIORAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:AVANZA BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EILIANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVELO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LABA
Authorized Official - Phone:413-433-2274
Mailing Address - Street 1:277 FALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:277 FALLEY DR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4913
Practice Address - Country:US
Practice Address - Phone:413-234-1707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty