Healthcare Provider Details

I. General information

NPI: 1023817202
Provider Name (Legal Business Name): ADONAI ELOHIM COMMUNITY HOUSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 WOODLAND AVE
NORTH PLAINFIELD NJ
07060-3330
US

IV. Provider business mailing address

1210 WOODLAND AVE
NORTH PLAINFIELD NJ
07060-3330
US

V. Phone/Fax

Practice location:
  • Phone: 718-909-1801
  • Fax:
Mailing address:
  • Phone: 718-909-1801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLE M MICHEL
Title or Position: OWNER
Credential:
Phone: 718-909-1801