MEDICARE: ADLIFE COMMUNITY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1073880050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADLIFE COMMUNITY SERVICES INC

Provider Business Mailing Address
First Line	:	3018 ROADRUNNER WALK
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-1111
Country	:	US
Telephone Number	:	832-891-8665
Fax Number	:	866-277-0461

Provider Business Practice Location Address
First Line	:	3018 ROADRUNNER WALK
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3542
Country	:	US
Telephone Number	:	832-891-8665
Fax Number	:	866-277-0461

Authorized Official
Title or Position	:	MANAGER
Name	:	CLARA OZUEH
Credential	:
Telephone Number	:	832-891-8655

Provider Enumeration Date	:	11/19/2011
Last Update Date	:	11/19/2011

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