Provider Demographics
NPI:1992125348
Name:AVANT-GARDE CARE AGENCY LLC
Entity type:Organization
Organization Name:AVANT-GARDE CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:AMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:UZOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-770-5673
Mailing Address - Street 1:9459 LANHAM SEVERN RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2641
Mailing Address - Country:US
Mailing Address - Phone:240-770-5673
Mailing Address - Fax:240-770-3701
Practice Address - Street 1:9459 LANHAM SEVERN RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2641
Practice Address - Country:US
Practice Address - Phone:240-770-5673
Practice Address - Fax:240-770-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3558251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care