Provider Demographics
NPI:1639825896
Name:AVANZOS EDUCATIONAL AND BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:AVANZOS EDUCATIONAL AND BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-451-0925
Mailing Address - Street 1:4107 MITSCHER CT
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1307
Mailing Address - Country:US
Mailing Address - Phone:515-451-0925
Mailing Address - Fax:
Practice Address - Street 1:4107 MITSCHER CT
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1307
Practice Address - Country:US
Practice Address - Phone:515-451-0925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health