Provider Demographics
NPI:1730705450
Name:NORA ADEYINKA
Entity type:Organization
Organization Name:NORA ADEYINKA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-245-3651
Mailing Address - Street 1:3103 LEXINGTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3198
Mailing Address - Country:US
Mailing Address - Phone:832-245-3651
Mailing Address - Fax:800-513-3753
Practice Address - Street 1:3103 LEXINGTON LAKE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3198
Practice Address - Country:US
Practice Address - Phone:832-245-3651
Practice Address - Fax:800-513-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities