MEDICARE: ADONAI CARE IN HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386479459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADONAI CARE IN HOME LLC

Provider Business Mailing Address
First Line	:	2817 W 7TH ST
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-1707
Country	:	US
Telephone Number	:	380-236-6246
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 W 7TH ST
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-1707
Country	:	US
Telephone Number	:	380-236-6246
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUNA CHARLES
Credential	:
Telephone Number	:	380-236-6246

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	09/06/2024

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