NPI | 1154817450 |
---|---|
Doing Business As | AVENUE 360 HEALTH AND WELLNESS |
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 | 2024-10-24 |