Provider Demographics
NPI:1912557141
Name:AZORA HEALTHCARE LLC
Entity Type:Organization
Organization Name:AZORA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADERONKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKANDE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:951-447-9429
Mailing Address - Street 1:1301 E BARDIN RD UNIT 183903
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76096-4358
Mailing Address - Country:US
Mailing Address - Phone:951-447-9429
Mailing Address - Fax:
Practice Address - Street 1:2307 OAK LN STE 201
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8286
Practice Address - Country:US
Practice Address - Phone:951-447-9429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health