Provider Demographics
NPI:1063831519
Name:ADORN MEDICAL CARE AND SERVICES INC
Entity Type:Organization
Organization Name:ADORN MEDICAL CARE AND SERVICES INC
Other - Org Name:NONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:NINI
Authorized Official - Last Name:VEBANGSI
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-792-0816
Mailing Address - Street 1:11113 CHERRYVALE TER
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3847
Mailing Address - Country:US
Mailing Address - Phone:301-792-0816
Mailing Address - Fax:
Practice Address - Street 1:11113 CHERRYVALE TER
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3847
Practice Address - Country:US
Practice Address - Phone:301-792-0816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251C00000X, 251E00000X, 251F00000X, 261QA0600X, 261QM0850X, 261QM0855X, 293D00000X, 305R00000X, 313M00000X
MDR150578302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No293D00000XLaboratoriesPhysiological Laboratory
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility