Provider Demographics
NPI:1619253770
Name:ADONAI HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:ADONAI HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:MEDINATH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:973-288-3141
Mailing Address - Street 1:165 TANGLEWOOD PASS
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2435
Mailing Address - Country:US
Mailing Address - Phone:973-288-3141
Mailing Address - Fax:
Practice Address - Street 1:165 TANGLEWOOD PASS
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2435
Practice Address - Country:US
Practice Address - Phone:973-288-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO12380000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID NUMBER