NPI 1063125185

Avonlea Opco LLC

Organisation Assisted Living Facility Tupelo, MS

Practice location

Address: 2429 Lawndale Dr, Tupelo, MS 38801-6493
Phone: (662) 840-6163
Mailing address: PO Box 2568, Hickory, NC 28603-2568

Authorised official

Name: Charles E Trefzger
Title: Manager
Phone: (828) 322-5535

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1063125185
Entity type: Organization
NPI issued: 4 Jan 2023
Record last updated: 4 Jan 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.