Provider Demographics
NPI:1053038554
Name:AVARA CARE AT-HOME LLC
Entity type:Organization
Organization Name:AVARA CARE AT-HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-450-0804
Mailing Address - Street 1:638 W BROADWAY RD STE 312
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-0908
Mailing Address - Country:US
Mailing Address - Phone:480-450-0804
Mailing Address - Fax:
Practice Address - Street 1:638 W BROADWAY RD STE 312
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-0908
Practice Address - Country:US
Practice Address - Phone:804-500-8044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care