NPIMap

Organization Active NPI

Avondale Health Services Inc

  • Assisted Living Facility
  • Decatur, GA
National Provider Identifier
1740662402
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
AVONDALE HEALTH SERVICES INC
Practice address
3508 Kensington Rd
Decatur, GA 30032-1328
Phone
(404) 294-0203
Fax
(404) 294-0208
NPI assigned
Jun 18, 2015
Last updated
Jun 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Trevor Anthony Waldemar
Title
Executive Director
Phone
(770) 912-5128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X GA Primary

Addresses

Primary practice location

3508 Kensington Rd
Decatur, GA 30032-1328

Mailing address

3508 Kensington Rd
Decatur, GA 30032-1328
Phone (404) 294-0203

National Provider Directory

National Provider Directory
Tax ID family
Avondale Health Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1740662402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 KENSINGTON RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321328",
            "telephone_number": "404-294-0203",
            "fax_number": "404-294-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 KENSINGTON RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321328",
            "telephone_number": "404-294-0203",
            "fax_number": "404-294-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVONDALE HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "WALDEMAR",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-912-5128"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.