Provider Demographics
NPI:1710117346
Name:AVINGTON CARE, INC.
Entity Type:Organization
Organization Name:AVINGTON CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAAL
Authorized Official - Middle Name:AVINGTON
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-454-1145
Mailing Address - Street 1:31038 HARPER BRANCH PL
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7123
Mailing Address - Country:US
Mailing Address - Phone:813-454-1145
Mailing Address - Fax:813-991-7860
Practice Address - Street 1:31038 HARPER BRANCH PL
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7123
Practice Address - Country:US
Practice Address - Phone:813-454-1145
Practice Address - Fax:813-991-7860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000945300251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000945301Medicaid
FL000945300Medicaid