# PEDIATRIC SERVICES OF AMERICA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aveanna Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720499932
- **Authorized official:** SHANNON DRAKE (CHIEF LEGAL OFFICER)
- **Authorized official phone:** (470) 464-8000

## Contact information

- **Practice address:** 55 MAIN ST UNIT 350, NORWICH, CT 06360-5760
- **Practice address phone:** (860) 383-1909
- **Practice address fax:** (860) 383-1914
- **Mailing address:** 400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
- **Mailing address phone:** (470) 464-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 9612701-PSO OFFICE | CT | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 05/12/2014
- **Last updated:** 02/28/2024