Provider Demographics
NPI:1992094288
Name:ADVENT ONE HOME CARE AGENCY INC
Entity type:Organization
Organization Name:ADVENT ONE HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:NYAGABONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-503-6854
Mailing Address - Street 1:10925 ESTATE LN STE 304
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2404
Mailing Address - Country:US
Mailing Address - Phone:214-503-6854
Mailing Address - Fax:214-503-6853
Practice Address - Street 1:10925 ESTATE LN STE 304
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2404
Practice Address - Country:US
Practice Address - Phone:214-503-6854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty