Provider Demographics
NPI:1073606083
Name:ADVENTIA HEALTHCARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ADVENTIA HEALTHCARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-419-2889
Mailing Address - Street 1:408 HWY 90 E
Mailing Address - Street 2:
Mailing Address - City:CASTROVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78009-4547
Mailing Address - Country:US
Mailing Address - Phone:210-579-4892
Mailing Address - Fax:830-538-5051
Practice Address - Street 1:408 HWY 90 E
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009-4547
Practice Address - Country:US
Practice Address - Phone:210-579-4892
Practice Address - Fax:830-538-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010136251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679553Medicare Oscar/Certification