Provider Demographics
NPI:1720722374
Name:AVALYN CARE LLC
Entity Type:Organization
Organization Name:AVALYN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHIAA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:651-428-6236
Mailing Address - Street 1:7306 PARRISH AVE NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-4519
Mailing Address - Country:US
Mailing Address - Phone:651-428-6236
Mailing Address - Fax:
Practice Address - Street 1:7306 PARRISH AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-4519
Practice Address - Country:US
Practice Address - Phone:651-428-6236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health