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Organization

AVENA STAFFING GROUP LLC

Active
Other names
Avena Company Limited Liability
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VICTORIA CHINYE EMENANJO BSC MBPA LPN (EXECUTIVE DIRECTOR)
(301) 725-6196
Entity
Organization

Contact information

Practice address
15036 COURTLAND PLACE, LAUREL, MD 20707
(301) 725-6196
(301) 776-6834
Mailing address
15036 COURTLAND PLACE, LAUREL, MD 20707
(301) 725-6196
(301) 776-6834

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
LP41016
MD
323P00000X
Psychiatric Residential Treatment Facility
R121487
MD
385H00000X
Respite Care
Primary
R121487
MD

Other

Enumeration date
07/23/2008
Last updated
07/23/2008
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