Organization
PEDIATRIC SERVICES OF AMERICA, LLC
Active
Other names
Aveanna Healthcare, PSA Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI WHITESIDE (AVP, REGULATORY LICENSING)
(770) 248-8740
Entity
Organization
Contact information
Practice address
2700 NE ANDRESEN RD, SUITE D-3, VANCOUVER, WA 98661-7347
(360) 693-7595
(360) 693-7262
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(770) 441-1580
(770) 248-8192
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
746106
—
WA
05
—
9049561
—
WA
Enumeration date
06/30/2006
Last updated
03/31/2021
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