Provider Demographics
NPI:1063835106
Name:AVENUE HEALTH CARE
Entity Type:Organization
Organization Name:AVENUE HEALTH CARE
Other - Org Name:SKY BLUE HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-265-2670
Mailing Address - Street 1:8000 CORPORATE CENTER DR
Mailing Address - Street 2:STE 112
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4464
Mailing Address - Country:US
Mailing Address - Phone:980-265-2670
Mailing Address - Fax:704-749-8608
Practice Address - Street 1:8000 CORPORATE CENTER DR
Practice Address - Street 2:STE 112
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4464
Practice Address - Country:US
Practice Address - Phone:980-265-2670
Practice Address - Fax:704-749-8608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251B00000X, 251E00000X, 251F00000X, 251G00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based