MEDICARE: ADONAI M&S 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	3747P1801X	Personal Care Attendant
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1518673128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADONAI M&S LLC

Provider Business Mailing Address
First Line	:	2504 RIO GRANDE DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-7877
Country	:	US
Telephone Number	:	214-717-0272
Fax Number	:

Provider Business Practice Location Address
First Line	:	2504 RIO GRANDE DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-7877
Country	:	US
Telephone Number	:	214-717-0272
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MIRANDA KWANE
Credential	:	RN
Telephone Number	:	214-717-0272

Provider Enumeration Date	:	01/26/2023
Last Update Date	:	01/26/2023

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Directions to “ADONAI M&S LLC ” Practice Location

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