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Organization

PEDIATRIA HEALTHCARE, LLC

Active
Other names
Aveanna Healthcare
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI WHITESIDE (DIRECTOR, REGULATORY LICENSING)
(770) 248-8740
Entity
Organization

Contact information

Practice address
1183 JACKS RUN RD, NORTH VERSAILLES, PA 15137-0000
(412) 349-6708
(412) 349-6716
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(770) 248-8740
(770) 248-8192

Taxonomy

Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021992800016
PA
Enumeration date
04/25/2013
Last updated
11/30/2018
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