Provider Demographics
NPI:1679340657
Name:ADEY HEALTHCARE LLC
Entity Type:Organization
Organization Name:ADEY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YETUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNJUMELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-807-7365
Mailing Address - Street 1:1100 WILCREST DR STE 121
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1642
Mailing Address - Country:US
Mailing Address - Phone:346-388-0388
Mailing Address - Fax:
Practice Address - Street 1:1100 WILCREST DR STE 121
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-1642
Practice Address - Country:US
Practice Address - Phone:346-388-0388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities