Provider Demographics
NPI:1780491951
Name:AVANT, DAMONE ANTELL JR
Entity type:Individual
Prefix:MR
First Name:DAMONE
Middle Name:ANTELL
Last Name:AVANT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 MEREDITH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2336
Mailing Address - Country:US
Mailing Address - Phone:402-490-7653
Mailing Address - Fax:
Practice Address - Street 1:3180 MEREDITH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2336
Practice Address - Country:US
Practice Address - Phone:402-490-7653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care