Provider Demographics
NPI:1922398668
Name:AVALON HOME CARE INC
Entity Type:Organization
Organization Name:AVALON HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARSHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:313-598-0567
Mailing Address - Street 1:21700 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 845
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4906
Mailing Address - Country:US
Mailing Address - Phone:248-557-6200
Mailing Address - Fax:248-557-6200
Practice Address - Street 1:21700 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 845
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4906
Practice Address - Country:US
Practice Address - Phone:248-557-6200
Practice Address - Fax:248-557-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health