NPIMap

Organization Active NPI

Avawell, LLC

  • Community/Behavioral Health Agency
  • Edgewood, MD
National Provider Identifier
1508387374
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AVAWELL, LLC
Practice address
1308 Business Center Way Ste 101
Edgewood, MD 21040-1504
Phone
(443) 992-5088
NPI assigned
Jul 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
James Omotosho
Title
Owner
Phone
(443) 992-5088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MD Primary

Addresses

Primary practice location

1308 Business Center Way Ste 101
Edgewood, MD 21040-1504

Mailing address

1308 Business Center Way Ste 101
Edgewood, MD 21040-1504

Other names 1

  • Mindset Support Services, LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Avawell LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1508387374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 BUSINESS CENTER WAY STE 101",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 BUSINESS CENTER WAY STE 101",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401504",
            "telephone_number": "443-992-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAWELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "OMOTOSHO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-992-5088"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindset Support Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Edgewood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.