Healthcare Provider Details

I. General information

NPI: 1578499265
Provider Name (Legal Business Name): AJOK ADIANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 W 93RD ST APT 4
SIOUX FALLS SD
57108-6367
US

IV. Provider business mailing address

4403 W VALHALLA BLVD APT 26
SIOUX FALLS SD
57106-5203
US

V. Phone/Fax

Practice location:
  • Phone: 888-535-2010
  • Fax:
Mailing address:
  • Phone: 888-535-2010
  • Fax: 800-294-7084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: