Organization
PEDIATRIC SERVICES OF AMERICA, LLC
Active
Other names
Aveanna Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BUCKHALTER (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
1000 BRIDGEPORT AVE STE 309, SHELTON, CT 06484-4660
(203) 381-1530
(203) 381-1535
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(470) 464-8000
(770) 248-8192
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
C9612701
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004217304
—
CT
05
—
4187953
—
CT
Enumeration date
07/25/2006
Last updated
01/27/2025
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