Provider Demographics
NPI:1134505852
Name:ADORAVILLE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ADORAVILLE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANGIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-448-9801
Mailing Address - Street 1:16830 IVY WILD LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4838
Mailing Address - Country:US
Mailing Address - Phone:713-448-9801
Mailing Address - Fax:
Practice Address - Street 1:16830 IVY WILD LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4838
Practice Address - Country:US
Practice Address - Phone:713-448-9801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care