Provider Demographics
NPI:1144548199
Name:AAVO HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:AAVO HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLANIYI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUPONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-701-9021
Mailing Address - Street 1:7997 W AIRPORT BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3058
Mailing Address - Country:US
Mailing Address - Phone:281-701-9021
Mailing Address - Fax:713-283-8801
Practice Address - Street 1:7997 W AIRPORT BLVD
Practice Address - Street 2:STE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3058
Practice Address - Country:US
Practice Address - Phone:281-701-9021
Practice Address - Fax:713-283-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013737251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health