MEDICARE: ADVENT ONE HOME CARE AGENCY 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	253Z00000X	In Home Supportive Care Agency
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1992094288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENT ONE HOME CARE AGENCY INC

Provider Business Mailing Address
First Line	:	10925 ESTATE LN STE 304
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-2404
Country	:	US
Telephone Number	:	214-503-6854
Fax Number	:	214-503-6853

Provider Business Practice Location Address
First Line	:	10925 ESTATE LN STE 304
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-2404
Country	:	US
Telephone Number	:	214-503-6854
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. STEPHEN G NYAGABONA
Credential	:
Telephone Number	:	214-503-6854

Provider Enumeration Date	:	04/07/2011
Last Update Date	:	05/29/2024

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