NPIMap

Organization Active NPI

Avena Staffing Group LLC

  • Respite Care
  • Laurel, MD
National Provider Identifier
1164687737
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
R121487 Issued in MD
Legal business name
AVENA STAFFING GROUP LLC
Practice address
15036 Courtland Place
Laurel, MD 20707
Phone
(301) 725-6196
Fax
(301) 776-6834
NPI assigned
Jul 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Mrs. Victoria Chinye Emenanjo, BSC MBPA LPN
Title
Executive Director
Phone
(301) 725-6196

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X LP41016 MD
Psychiatric Residential Treatment Facility 323P00000X R121487 MD
Respite Care 385H00000X R121487 MD Primary

Addresses

Primary practice location

15036 Courtland Place
Laurel, MD 20707

Mailing address

15036 Courtland Place
Laurel, MD 20707
Phone (301) 725-6196

Other names 1

  • Avena Company Limited Liability Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1164687737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15036 COURTLAND PLACE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-725-6196",
            "fax_number": "301-776-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15036 COURTLAND PLACE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-725-6196",
            "fax_number": "301-776-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENA STAFFING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "EMENANJO",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "CHINYE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-725-6196",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSC MBPA LPN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MD",
            "license": "LP41016",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "MD",
            "license": "R121487",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MD",
            "license": "R121487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avena Company Limited Liability",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.