Avalon Centers, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9255320A Issued in NY

Legal business name

AVALON CENTERS, INC.

Practice address

346 Harris Hill Rd
Williamsville, NY 14221-7407

Phone

(716) 839-0999

Fax

(716) 839-2058

NPI assigned

Mar 22, 2006

Organization subpart

No

Name

Mr. Arthur Boese

Title

Ceo

Phone

(716) 839-0999

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013976513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 HARRIS HILL RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217407",
            "telephone_number": "716-839-0999",
            "fax_number": "716-839-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 HARRIS HILL RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217407",
            "telephone_number": "716-839-0999",
            "fax_number": "716-839-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOESE",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-839-0999",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "9255320A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00030010901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "050505000054",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "8090017",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000526352001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7340621",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.