=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578499265
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AJOK ADIANG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2026
-----------------------------------------------------
Last Update Date | 06/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3708 W 93RD ST APT 4
-----------------------------------------------------
City | SIOUX FALLS
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57108-6367
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-535-2010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4403 W VALHALLA BLVD APT 26
-----------------------------------------------------
City | SIOUX FALLS
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57106-5203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-535-2010
-----------------------------------------------------
Fax | 800-294-7084
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------