Organization
PEDIATRIC SERVICES OF AMERICA, LLC
Active
Other names
Aveanna Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID AFSHAR (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
126 INTEGRA BREEZE LN STE 3B, DAYTONA BEACH, FL 32117-5554
(386) 304-0702
(386) 304-0703
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
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
681259796
—
FL
Enumeration date
10/27/2021
Last updated
02/09/2022
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