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General NPI Number Information
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NPI Number | 1306758107
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Entity Type | Organization
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Legal Business Name | PROVENTUS HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 4117 SUN MEADOW LN
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City | SEGUIN
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State | TX
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Zip | 78155-2888
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Country | US
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Telephone | 830-318-3292
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Fax |
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Provider Business Mailing Address
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Address Line | 102 WONDER WORLD DR STE 304
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City | SAN MARCOS
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State | TX
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Zip | 78666-6070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KANIA AWOLAJA
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Credential |
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Telephone | 830-318-3292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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