Basic Information
| Provider Information | |||||||||
| NPI: | 1124785506 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EPIC HEALTH SERVICES, INC. | ||||||||
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| OtherOrganizationName: | AVEANNA HEALTHCARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 INTERSTATE NORTH PKWY SE STE 1600 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303395047 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1901 MEDI PARK DR STE 2048A | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791062109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067804180 | ||||||||
| FaxNumber: | 8663621736 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2021 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | SPEER | ||||||||
| AuthorizedOfficialFirstName: | KATE | ||||||||
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| AuthorizedOfficialTitleorPosition: | AVP | ||||||||
| AuthorizedOfficialTelephone: | 4704648000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | 251E00000X | Y | Agencies | Home Health |
No ID Information.