| NPI | 1912411174 |
|---|---|
| Doing Business As | AVANTARA OF CAMERON PARK |
| Entity Type | Organization |
| Authorized Contact | MENACHEM SHABAT COO/Owner 847-679-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2018-08-23 |