Provider Demographics
NPI:1144580036
Name:ENVITAL INCORPORATED
Entity Type:Organization
Organization Name:ENVITAL INCORPORATED
Other - Org Name:ENVITAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEDOTUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEBOWALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-814-5100
Mailing Address - Street 1:18150 SORRELL OAKS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2496
Mailing Address - Country:US
Mailing Address - Phone:832-814-5100
Mailing Address - Fax:832-848-1277
Practice Address - Street 1:18150 SORRELL OAKS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2496
Practice Address - Country:US
Practice Address - Phone:832-814-5100
Practice Address - Fax:832-848-1277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health