Avanti Wellness Center Inc

LBN: Avanti Wellness Center Inc
Avanti Wellness Center Inc is an health care organization with primary practice located at 165 Southpark Blvd Suite D, St Augustine FL 32086-4101. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Avanti Wellness Center Inc can be contacted via phone (904) 824-7597, or through Odom, Denise R via phone (904) 824-7597.

Contact Information

Primary practice address
165 Southpark Blvd Suite D St Augustine FL 32086-4101
Phone: (904) 824-7597
Fax: (904) 824-7598
Website:
Map and Directions
Authorized official contact:
Name: Odom, Denise R
Phone: (904) 824-7597

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY7098 Florida
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW5151 Florida

Profile Details

NPI number 1861403974
LBN Legal business name Avanti Wellness Center Inc
DBA Doing business as
Authorized official Odom, Denise R
Entity Organization
Organization subpart 1 No
Enumeration date Aug 11th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861403974 NPPES
Florida Other HCC7024 MEDICAL LICENSE NUMBER

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