Avon Behavioral Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AVON BEHAVIORAL SERVICES LLC

Practice address

4485 Verdon St Unit 1161
North Las Vegas, NV 89031-4431

Phone

(510) 825-6012

NPI assigned

Oct 2, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shaquail M Montgomery

Title

Owner

Phone

(510) 825-6012

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1083432512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 LOFTY LN SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318638",
            "telephone_number": "510-825-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 VERDON ST UNIT 1161",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314431",
            "telephone_number": "510-825-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "SHAQUAIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-825-6012"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Avila
• Liliana Avila, RN
• Nestor Avila
• Julianna Aviles-Martinez
• Jorge M Avita-Soto
• Andrea M Awerbach
• Paulina Awuah-Saadiq
• Jaleesah N Ayala-Sanchez
• Aldo Ayala
• Alfonso Erasmo Escobar Ayala

• Community/Behavioral Health Agency in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.