Avie Ida's Enterprises LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AVIE IDA'S ENTERPRISES LLC

Practice address

1 Carrie Place
Sicklerville, NJ 08081

Phone

(215) 380-5441

NPI assigned

Apr 25, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Jessica Kathline Coursey

Title

Owner

Phone

(267) 216-7239

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1295423648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CARRIE PLACE",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "08081",
            "telephone_number": "215-380-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CARRIE PLACE",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "08081",
            "telephone_number": "215-380-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIE IDA'S ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "COURSEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "KATHLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-216-7239",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.