Provider Demographics
NPI:1528314820
Name:AVATAR HOME HEALTH CARE AGENCY, LLC
Entity type:Organization
Organization Name:AVATAR HOME HEALTH CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:N
Authorized Official - Last Name:CANABAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-465-8220
Mailing Address - Street 1:25325 BOROUGH PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3564
Mailing Address - Country:US
Mailing Address - Phone:281-465-8220
Mailing Address - Fax:281-298-7502
Practice Address - Street 1:25325 BOROUGH PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3564
Practice Address - Country:US
Practice Address - Phone:281-465-8220
Practice Address - Fax:281-298-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty