Provider Demographics
NPI:1346885720
Name:AMAREVIDA, LLC
Entity Type:Organization
Organization Name:AMAREVIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEALS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:888-355-8432
Mailing Address - Street 1:2754 KINGS RETREAT CIR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-5600
Mailing Address - Country:US
Mailing Address - Phone:281-798-0057
Mailing Address - Fax:
Practice Address - Street 1:2754 KINGS RETREAT CIR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-5600
Practice Address - Country:US
Practice Address - Phone:281-798-0057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-09
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care