Avalon Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AVALON HOME CARE LLC

Practice address

990 Spruce St Ste 206
Lawrence, NJ 08648-4566

Phone

(609) 964-7756

Fax

(866) 520-7846

NPI assigned

Oct 28, 2024

Last updated

Oct 28, 2024By 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

Arkadiy Isakov

Title

Owner

Phone

(917) 400-9700

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1740002047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SPRUCE ST STE 206",
            "city": "LAWRENCE",
            "state": "NJ",
            "postal_code": "086484566",
            "telephone_number": "609-964-7756",
            "fax_number": "866-520-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SPRUCE ST STE 206",
            "city": "LAWRENCE",
            "state": "NJ",
            "postal_code": "086484566",
            "telephone_number": "609-964-7756",
            "fax_number": "866-520-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "ISAKOV",
        "authorized_official_first_name": "ARKADIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-400-9700"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Lawrence, NJ
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• In Home Supportive Care Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.