Provider Demographics
NPI:1154156420
Name:AVOCARE HEALTH SERVICES
Entity type:Organization
Organization Name:AVOCARE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-275-1885
Mailing Address - Street 1:6 PARKLANE BLVD STE 525
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4210
Mailing Address - Country:US
Mailing Address - Phone:810-275-1885
Mailing Address - Fax:810-391-2263
Practice Address - Street 1:6 PARKLANE BLVD STE 525
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4210
Practice Address - Country:US
Practice Address - Phone:810-275-1885
Practice Address - Fax:810-391-2263
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AVOCARE HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty