Provider Demographics
NPI:1245778158
Name:ADOM FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:ADOM FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YAA KYEREMAA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMPO ADDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-239-3410
Mailing Address - Street 1:305 WHITNEY ST
Mailing Address - Street 2:SUITE G4
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3280
Mailing Address - Country:US
Mailing Address - Phone:774-239-3410
Mailing Address - Fax:
Practice Address - Street 1:305 WHITNEY ST
Practice Address - Street 2:SUITE G4
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3280
Practice Address - Country:US
Practice Address - Phone:774-239-3410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities