Provider Demographics
NPI:1619527439
Name:AVADIS RESIDENTIAL LIVING SERVICES LLC
Entity Type:Organization
Organization Name:AVADIS RESIDENTIAL LIVING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:281-654-6012
Mailing Address - Street 1:9115 FM 723 RD STE 500-328
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-9234
Mailing Address - Country:US
Mailing Address - Phone:281-654-6012
Mailing Address - Fax:
Practice Address - Street 1:9115 FM 723 RD STE 500-328
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-9234
Practice Address - Country:US
Practice Address - Phone:281-654-6012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health