Avatar, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

A00815 Issued in UT

Legal business name

AVATAR, INC.

Practice address

4042 Pacific Ave Ste 3
Riverdale, UT 84405-1689

Phone

(801) 392-7485

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Jeanette Drews, PHD

Title

Ceo

Phone

(801) 392-7485

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801937461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4042 PACIFIC AVE STE 3",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844051689",
            "telephone_number": "801-392-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4042 PACIFIC AVE STE 3",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844051689",
            "telephone_number": "801-392-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVATAR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DREWS",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-392-7485",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "UT",
            "license": "A00815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Riverdale, UT
• Providers in Riverdale, UT by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.