Avanta Support Services Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

AVANTA SUPPORT SERVICES INC

Practice address

4105 Kiwi CT
Randallstown, MD 21133-4059

Phone

(631) 933-5682

NPI assigned

Oct 14, 2026

Last updated

Oct 14, 2026By 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

Chizoba Emmanuel

Title

Ceo

Phone

(631) 933-5682

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1770488157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 KIWI CT",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 KIWI CT",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334059",
            "telephone_number": "631-933-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTA SUPPORT SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "EMMANUEL",
        "authorized_official_first_name": "CHIZOBA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-933-5682"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ati Holding LLC (ATI Physical Therapy)
• Ati Holdings, LLC (ATI Physical Therapy Randallstown)
• Elizabeth M Atkinson, PA-C
• Audience Wellness and Behavioral Healthcare LLC
• Felicia M. Austin, M.D.
• Avverahalli Harish MD PA
• Ngum Avwontom, FNP, CRNP
• Awaken Health Group Inc
• Martin Anu Awung
• Zahraa M Babiker Mohammed, PHARM D

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.