=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336718972
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADSYSTECH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2021
-----------------------------------------------------
Last Update Date | 06/18/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11785 BELTSVILLE DR STE 1350
-----------------------------------------------------
City | BELTSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20705-4051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-589-3434
-----------------------------------------------------
Fax | 301-589-9254
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11785 BELTSVILLE DR STE 1350
-----------------------------------------------------
City | BELTSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20705-4051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-589-3434
-----------------------------------------------------
Fax | 301-589-9254
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ARNOLD AVANT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 301-589-3434
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------