Healthcare Provider Details

I. General information

NPI: 1982297933
Provider Name (Legal Business Name): ADORATION HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 BRIARVILLE RD
MADISON TN
37115-5141
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-7101
US

V. Phone/Fax

Practice location:
  • Phone: 615-610-0568
  • Fax: 629-204-3099
Mailing address:
  • Phone: 502-272-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: REXANNE DOMICO
Title or Position: DIRECTOR & PRESIDENT
Credential:
Phone: 502-272-3466