=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528353794
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADONAI HEALTHCARE SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2011
-----------------------------------------------------
Last Update Date | 06/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9199 REISTERSTOWN RD STE 216C
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-4577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-521-7004
-----------------------------------------------------
Fax | 410-521-7005
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9216 LIBERTY RD
-----------------------------------------------------
City | RANDALLSTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21133-3544
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-521-7004
-----------------------------------------------------
Fax | 410-521-7005
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. DEMI OLASIMBO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-521-7004
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | R2474
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------