Avalon at Home, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AVALON AT HOME, LLC

Practice address

1500 Walnut St Ste 1900
Downingtown, PA 19335

Phone

(215) 330-2912

NPI assigned

Apr 9, 2019

Last updated

Apr 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adiam Tesfahuney Keleta

Title

Ceo/Director

Phone

(215) 330-2912

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554768000000",
    "number": "1679036487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 NANCY LN",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "19335",
            "telephone_number": "215-330-2912",
            "fax_number": "215-330-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WALNUT ST STE 1900",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "19335",
            "telephone_number": "215-330-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A",
        "authorized_official_last_name": "KELETA",
        "authorized_official_first_name": "ADIAM",
        "authorized_official_middle_name": "TESFAHUNEY",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "215-330-2912"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26300539",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Downingtown, PA
• Providers in Downingtown, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.