Provider Demographics
NPI:1386467421
Name:AHAVA SHELI LLC
Entity type:Organization
Organization Name:AHAVA SHELI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUNTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-299-7773
Mailing Address - Street 1:2112 BELLATRIX DR
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-3490
Mailing Address - Country:US
Mailing Address - Phone:940-299-7773
Mailing Address - Fax:
Practice Address - Street 1:2112 BELLATRIX DR
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3490
Practice Address - Country:US
Practice Address - Phone:940-299-7773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care