AVATAR, INC. (NPI# 1801937461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801937461 |
| Entity Type | Organization |
| Organization Name | AVATAR, INC. |
| Practice Address |
4042 Pacific Ave Ste 3 Riverdale UT 84405-1689 |
| Practice Telephone | 8013927485 |
| Mailing Telephone | 8013927485 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JEANETTE DREWS (CEO) |
| Authorized Official Telephone | 8013927485 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | A00815 | UT | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | AVATAR, INC. | 1979 Se Ladd Ave, Portland, OR 97214 |
| New York State Corporations | AVATAR, INC. | 4831 Lewiston Rd., Niagara, Ny 14305 |
| Street Address |
4042 PACIFIC AVE STE 3 |
| City | RIVERDALE |
| State | UT |
| Zip Code | 84405-1689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992076947 | New Way Care Home Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1262 King Rd, Riverdale, GA 30296-2952 | 2012-01-23 |
| 1790951556 | Lifetouch Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7002 Beacon Pl, Riverdale, MD 20737-1774 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629447370 | Rha Health Service Ut LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 650 S University St, Salt Lake City, UT 84102-3213 | 2015-09-23 |
| 1518340173 | Youth Health Associates, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 920 North 000 West, Manti, UT 84642-1065 | 2015-07-01 |
| 1689078453 | Valley Behavioral Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 198 West 7200 South, Midvale, UT 84047 | 2014-10-22 |
| 1659785368 | Brittney Spencer | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 191 N 700 W, Layton, UT 84041-4654 | 2014-06-20 |
| 1386995611 | Intellegis, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 333 E Clark St, Murray, UT 84107-4916 | 2012-09-26 |
| 1679852172 | Road To Success Youth Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4687 Rain Tree Way, West Valley City, UT 84120-1756 | 2011-08-15 |
| 1861679367 | Learning Services Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1259 W 13200 S, Riverton, UT 84065-6128 | 2008-01-28 |
| 1093833683 | Freewill Foundation Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 344 N 100 W, Centerfield, UT 84622 | 2007-03-26 |
| 1679690804 | Stepping Stoneschild Placement Agency | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 180 E 2100 S, 201b, Salt Lake City, UT 84115-2328 | 2007-03-23 |
| 1073662284 | Care Treatment and Recreation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2057 Meadowlark Way, Sandy, UT 84093 | 2007-01-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.