Provider Demographics
NPI:1184404642
Name:AVIV VILLAGES LLC
Entity type:Organization
Organization Name:AVIV VILLAGES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DION
Authorized Official - Middle Name:
Authorized Official - Last Name:ATCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-417-4631
Mailing Address - Street 1:2955 BROWNWOOD BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163-2040
Mailing Address - Country:US
Mailing Address - Phone:407-417-4631
Mailing Address - Fax:
Practice Address - Street 1:2955 BROWNWOOD BLVD STE 100
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2040
Practice Address - Country:US
Practice Address - Phone:407-417-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AVIV USA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty