MEDICARE: ADONISSON HEALTH CARE, 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1710817770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADONISSON HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	1409 GREENVIEW WAY
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-3039
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1409 GREENVIEW WAY
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-3039
Country	:	US
Telephone Number	:	770-717-2751
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IN HWANG
Credential	:
Telephone Number	:	470-974-7220

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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