Provider Demographics
NPI:1811645856
Name:AVLIAN MENTAL HEALTH CARE LLC
Entity type:Organization
Organization Name:AVLIAN MENTAL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADONYE
Authorized Official - Middle Name:
Authorized Official - Last Name:AFONYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-564-2050
Mailing Address - Street 1:3936 E. FRONTAGE RD. HWY. 52 N
Mailing Address - Street 2:PMB 182
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901
Mailing Address - Country:US
Mailing Address - Phone:507-564-2050
Mailing Address - Fax:
Practice Address - Street 1:3936 E. FRONTAGE RD. HWY. 52 N
Practice Address - Street 2:PMB 182
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-564-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty