Provider Demographics
NPI:1174955082
Name:AVENUE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:AVENUE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:K.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-786-6755
Mailing Address - Street 1:1111 BELT LINE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3299
Mailing Address - Country:US
Mailing Address - Phone:469-786-6755
Mailing Address - Fax:
Practice Address - Street 1:1111 BELT LINE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3299
Practice Address - Country:US
Practice Address - Phone:469-786-6755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health