Provider Demographics
NPI:1447797949
Name:AVENUES FOR HEALTH
Entity Type:Organization
Organization Name:AVENUES FOR HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLAUME
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:515-460-2962
Mailing Address - Street 1:425 S 2ND ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-7038
Mailing Address - Country:US
Mailing Address - Phone:515-460-2962
Mailing Address - Fax:
Practice Address - Street 1:425 S 2ND ST
Practice Address - Street 2:SUITE #2
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-7038
Practice Address - Country:US
Practice Address - Phone:515-460-2962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA081379225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty