Organization
PEDIATRIC SERVICES OF AMERICA, LLC
Active
Other names
Aveanna Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI WHITESIDE (AVP)
(470) 464-8000
Entity
Organization
Contact information
Practice address
8659 BAYPINE ROAD, STE 100, BUILDING 3, JACKSONVILLE, FL 32256
(904) 730-2200
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
678778965
—
FL
Enumeration date
10/27/2021
Last updated
10/27/2021
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