Provider Demographics
NPI:1831576909
Name:AVENUE HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:AVENUE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MYO
Authorized Official - Middle Name:
Authorized Official - Last Name:TUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-978-6060
Mailing Address - Street 1:3142 TIGER RUN CT STE 117
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6694
Mailing Address - Country:US
Mailing Address - Phone:760-978-6060
Mailing Address - Fax:
Practice Address - Street 1:3142 TIGER RUN CT STE 117
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6694
Practice Address - Country:US
Practice Address - Phone:760-978-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health