Provider Demographics
NPI:1902371859
Name:AVENUES UNLIMITED COUNSELING CENTER
Entity Type:Organization
Organization Name:AVENUES UNLIMITED COUNSELING CENTER
Other - Org Name:AVENUES UNLIMITED COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:502-303-2929
Mailing Address - Street 1:3800 NORBOURNE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3751
Mailing Address - Country:US
Mailing Address - Phone:502-303-2929
Mailing Address - Fax:
Practice Address - Street 1:3701 TAYLORSVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1351
Practice Address - Country:US
Practice Address - Phone:502-459-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health