=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942491238
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVENTURES ONE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2007
-----------------------------------------------------
Last Update Date | 06/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4409 EAST WEST HIGHWAY
-----------------------------------------------------
City | RIVERDALE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 20737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-277-3337
-----------------------------------------------------
Fax | 301-277-0064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7121 OLD ALEXANDRIA FERRY RD
-----------------------------------------------------
City | CLINTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-856-5553
-----------------------------------------------------
Fax | 301-856-5512
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | ELEANOR L BONNER
-----------------------------------------------------
Credential | MS RN
-----------------------------------------------------
Telephone | 301-856-5553
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------