AVALON HOSPICE MINNESOTA LLC NPI 1902343353

NPI Information

NPI: 1902343353
Provider Name: AVALON HOSPICE MINNESOTA, LLC

Doing Business As: GENTIVA

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
1821 UNIVERSITY AVE W
SAINT PAUL, MN
ZIP 55104
Phone: (612) 361-0022
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AVALON HOSPICE MINNESOTA, LLC is a hospice care community based in Saint Paul, MN. AVALON HOSPICE MINNESOTA, LLC NPI is 1902343353. The provider is registered as an organization entity type.
The provider Is Doing Business As Gentiva.

The provider's business location address is:

1821 UNIVERSITY AVE W
SAINT PAUL, MN
ZIP 55104-801
Phone: (612) 361-0022
Fax: (844) 587-4798

The provider's authorized official is Janet Combs .
The authorized official title is Vp Of Licensure and has the following contact phone number (704) 664-2876.

The CLIA number assigned to this NPI record is 24D2128716 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2017 and was last updated on 1/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1902343353	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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