Provider Demographics
NPI:1225808785
Name:ADELIS HEALTH PLLC
Entity Type:Organization
Organization Name:ADELIS HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADITYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SRINIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-309-2333
Mailing Address - Street 1:200 BOSTON AVE STE 1925
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 BOSTON AVE STE 1925
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4243
Practice Address - Country:US
Practice Address - Phone:617-533-0416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty