Provider Demographics
NPI:1336590181
Name:ADVENT THERAPY LLC
Entity Type:Organization
Organization Name:ADVENT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-624-6882
Mailing Address - Street 1:3500 HILLCREST DR
Mailing Address - Street 2:STE. 1
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-3144
Mailing Address - Country:US
Mailing Address - Phone:888-624-6882
Mailing Address - Fax:888-882-4498
Practice Address - Street 1:3500 HILLCREST DR
Practice Address - Street 2:STE. 1
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3144
Practice Address - Country:US
Practice Address - Phone:888-624-6882
Practice Address - Fax:888-882-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty