| NPI | 1154817450 |
|---|---|
| Other Name | AVENUE 360 NORTHEAST |
| Entity Type | Organization |
| Authorized Contact | TEQUILA HENDERSON Revenue Cycle Director 713-426-0027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2024-05-09 |