Provider Demographics
NPI:1780215194
Name:AVIDA HOME HEALTH LLC
Entity Type:Organization
Organization Name:AVIDA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-475-1788
Mailing Address - Street 1:6595 S DAYTON ST STE 3400
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6155
Mailing Address - Country:US
Mailing Address - Phone:720-475-1788
Mailing Address - Fax:720-306-5282
Practice Address - Street 1:6595 S DAYTON ST STE 3400
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-6155
Practice Address - Country:US
Practice Address - Phone:720-475-1788
Practice Address - Fax:720-306-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health