Provider Demographics
NPI:1285665299
Name:ADALIGHT HOME HEALTH LLC
Entity Type:Organization
Organization Name:ADALIGHT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:IHEANYI
Authorized Official - Last Name:NWANERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-926-4558
Mailing Address - Street 1:3200 BROADWAY BLVD STE 274
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1577
Mailing Address - Country:US
Mailing Address - Phone:972-926-4558
Mailing Address - Fax:972-926-4919
Practice Address - Street 1:3200 BROADWAY BLVD STE 274
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1577
Practice Address - Country:US
Practice Address - Phone:972-926-4558
Practice Address - Fax:972-926-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005253251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001007825Medicaid
TX001007029Medicaid
TX001016434Medicaid
TX001012748Medicaid
TX001007824Medicaid
TX001012470Medicaid
TX001007029Medicaid