Provider Demographics
NPI:1104412865
Name:AVENEL HEALTHCARE INC.
Entity type:Organization
Organization Name:AVENEL HEALTHCARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:I
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-535-3736
Mailing Address - Street 1:1401 MERCANTILE LN STE 203
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4304
Mailing Address - Country:US
Mailing Address - Phone:240-582-7775
Mailing Address - Fax:240-582-7972
Practice Address - Street 1:1401 MERCANTILE LN STE 203
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4304
Practice Address - Country:US
Practice Address - Phone:240-582-7775
Practice Address - Fax:240-582-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care