Provider Demographics
NPI:1114459336
Name:IT'S ADONAI
Entity Type:Organization
Organization Name:IT'S ADONAI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RETHEMIOUS
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:1256-797-3113
Mailing Address - Street 1:2813 WASHINGTON ST NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-1639
Mailing Address - Country:US
Mailing Address - Phone:256-797-3113
Mailing Address - Fax:
Practice Address - Street 1:2813 WASHINGTON ST NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-1639
Practice Address - Country:US
Practice Address - Phone:256-797-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X, 252Y00000X
AL1-139627251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No252Y00000XAgenciesEarly Intervention Provider Agency