| Organization Name: | AVENAL COMMUNITY HEALTH CENTER |
| NPI Number: | 1225387616 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN D BLAINE (CEO/ADMINISTRATOR) |
| Mailing Address: | 1000 Skyline Blvd Mobile Unit 1 Avenal |
| State: | CA US |
| Postal Code: | 932041850 |
| Phone Number: | 5593864500 |
| Fax Number: | 5593860999 |
| NPI Enumeration Date: | 08/31/2012 |
| NPI Last Update Date: | 08/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 550002057 |
| 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: | |