Provider Demographics
NPI:1184977837
Name:ADONAI'S LIVING CENTER, INC
Entity type:Organization
Organization Name:ADONAI'S LIVING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAGHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-289-8085
Mailing Address - Street 1:17015 COSTERO DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-3658
Mailing Address - Country:US
Mailing Address - Phone:832-289-8085
Mailing Address - Fax:713-270-6501
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:590
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:832-289-8085
Practice Address - Fax:713-270-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities