Provider Demographics
NPI:1093046989
Name:ADAMS, SECONIA
Entity Type:Individual
Prefix:
First Name:SECONIA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7528 SW 7TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-1311
Mailing Address - Country:US
Mailing Address - Phone:954-724-8273
Mailing Address - Fax:954-724-8273
Practice Address - Street 1:7528 SW 7TH PL
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-1311
Practice Address - Country:US
Practice Address - Phone:954-724-8273
Practice Address - Fax:954-724-8273
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities