Provider Demographics
NPI:1306206503
Name:DAVAZE CONSULTANT LLC
Entity type:Organization
Organization Name:DAVAZE CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-376-0623
Mailing Address - Street 1:230 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2885
Mailing Address - Country:US
Mailing Address - Phone:229-376-0623
Mailing Address - Fax:
Practice Address - Street 1:230 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2885
Practice Address - Country:US
Practice Address - Phone:229-376-0623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare