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PEDIATRIA HEALTHCARE LLC NPI 1922409069


NPI Information

NPI: 1922409069
Provider Name: PEDIATRIA HEALTHCARE, LLC

Doing Business As: AVEANNA HEALTHCARE

Classification: Clinic/Center - 261QM3000X
Entity Type: Organization

Specialization: Medically Fragile Infants and Children Day Care

CLIA Number: 19D2083631

Address:
385 BERT KOUNS INDUSTRIAL LOOP
SUITE 600
SHREVEPORT, LA
ZIP 71106
Phone: (318) 415-7625
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PEDIATRIA HEALTHCARE, LLC is a medically fragile infants and children day care clinic center in Shreveport, LA. The provider is an entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). PEDIATRIA HEALTHCARE, LLC NPI is 1922409069. The provider is registered as an organization entity type.
The provider Is Doing Business As Aveanna Healthcare.

The provider's business location address is:

385 BERT KOUNS INDUSTRIAL LOOP
SUITE 600
SHREVEPORT, LA
ZIP 71106-158
Phone: (318) 415-7625
Fax: (318) 415-7630

The provider's authorized official is Shannon Drake .
The authorized official title is Chief Legal Officer and has the following contact phone number (470) 464-8000.

The CLIA number assigned to this NPI record is 19D2083631 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2014 and was last updated on 2/5/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM3000XClinic/CenterMedically Fragile Infants and Children Day CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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