Provider Demographics
NPI:1235019126
Name:ADULT & GERO HOME CARE LLC
Entity type:Organization
Organization Name:ADULT & GERO HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-494-2300
Mailing Address - Street 1:2915 GRAND LOOKOUT LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-4601
Mailing Address - Country:US
Mailing Address - Phone:617-494-2300
Mailing Address - Fax:
Practice Address - Street 1:1301 S BOWEN RD
Practice Address - Street 2:STE 140 OFFICE A-03
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013
Practice Address - Country:US
Practice Address - Phone:617-494-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care