Organization
AVON BEHAVIORAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAQUAIL M MONTGOMERY (OWNER)
(510) 825-6012
Entity
Organization
Contact information
Practice address
4485 VERDON ST UNIT 1161, NORTH LAS VEGAS, NV 89031-4431
(510) 825-6012
Mailing address
629 LOFTY LN SW, ATLANTA, GA 30331-8638
(510) 825-6012
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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