| Organization Name: | AVENAL COMMUNITY HEALTH CENTER |
| NPI Number: | 1073868527 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN D BLAINE (CEO / ADMINISTRATOR) |
| Mailing Address: | 140 C St Lemoore |
| State: | CA US |
| Postal Code: | 932452929 |
| Phone Number: | 5599247005 |
| Fax Number: | 5599243197 |
| NPI Enumeration Date: | 07/20/2012 |
| NPI Last Update Date: | 08/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 550001875 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |