Provider Demographics
NPI:1477250132
Name:AD MODUM SOLUTIONS
Entity Type:Organization
Organization Name:AD MODUM SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:NJIANDE
Authorized Official - Last Name:BELALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-412-8786
Mailing Address - Street 1:2321 4TH ST NE APT 304
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1292
Mailing Address - Country:US
Mailing Address - Phone:240-413-8786
Mailing Address - Fax:202-269-3236
Practice Address - Street 1:2321 4TH ST NE APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1292
Practice Address - Country:US
Practice Address - Phone:240-413-8786
Practice Address - Fax:202-269-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services