Provider Demographics
NPI:1306141122
Name:AVERY INVESTMENTS OF SCOTTSDALE CORP
Entity type:Organization
Organization Name:AVERY INVESTMENTS OF SCOTTSDALE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ASPENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-451-8800
Mailing Address - Street 1:15030 N HAYDEN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2578
Mailing Address - Country:US
Mailing Address - Phone:480-451-8800
Mailing Address - Fax:480-315-0220
Practice Address - Street 1:15030 N HAYDEN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2578
Practice Address - Country:US
Practice Address - Phone:480-451-8800
Practice Address - Fax:480-315-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ152831Medicaid