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
110 HORIZON DR STE 100, RALEIGH, NC 27615-4927
(919) 341-3933
(919) 341-7234
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
—
—
251J00000X
Nursing Care Agency
Primary
HC0828
NC
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408666
—
NC
05
—
7100325
—
NC
Enumeration date
06/28/2006
Last updated
04/22/2026
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