Organization
AVENUE HOMECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SERENA LYNN BROCK (ADMINISTRATOR)
(704) 971-2817
Entity
Organization
Contact information
Practice address
1511 E 7TH ST, CHARLOTTE, NC 28204-2409
(704) 971-2800
(704) 527-6616
Mailing address
1511 E 7TH ST, CHARLOTTE, NC 28204-2409
(704) 971-2800
(704) 527-6616
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2494
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409669
—
NC
05
—
6601048
—
NC
05
—
7100519
—
NC
Enumeration date
07/26/2005
Last updated
08/22/2020
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