# AVALON HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740002047
- **Authorized official:** ARKADIY ISAKOV (OWNER)
- **Authorized official phone:** (917) 400-9700

## Contact information

- **Practice address:** 990 SPRUCE ST STE 206, LAWRENCE, NJ 08648-4566
- **Practice address phone:** (609) 964-7756
- **Practice address fax:** (866) 520-7846
- **Mailing address:** 990 SPRUCE ST STE 206, LAWRENCE, NJ 08648-4566
- **Mailing address phone:** (609) 964-7756
- **Mailing address fax:** (866) 520-7846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/28/2024
- **Last updated:** 10/28/2024