Provider Demographics
NPI:1215673256
Name:LAVNI, INC
Entity type:Organization
Organization Name:LAVNI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:AZEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-460-4292
Mailing Address - Street 1:804 S GARNETT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-4571
Mailing Address - Country:US
Mailing Address - Phone:980-890-7522
Mailing Address - Fax:
Practice Address - Street 1:804 S GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4571
Practice Address - Country:US
Practice Address - Phone:980-890-7522
Practice Address - Fax:980-890-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)