Doctor Name: | DANA L AVANT |
NPI Number: | 1902227465 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 571233178 |
Business Practice Address: | 2212 Hollywood Ave Eustis, FL - 327263218 |
Business Phone Number: | 3523482016 |
Business Fax Number: | |
Mailing Address: | 2212 Hollywood Ave, EUSTIS |
State: | FL |
Postal Code: | 327263218 |
Phone Number: | 3523482016 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2013 |
NPI Last Update Date: | 12/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | 571233178 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |