Provider Demographics
NPI:1629537238
Name:ADELFOS LLC
Entity Type:Organization
Organization Name:ADELFOS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:QIDP
Authorized Official - Phone:801-471-9314
Mailing Address - Street 1:308 W WILLOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-4814
Mailing Address - Country:US
Mailing Address - Phone:801-471-9314
Mailing Address - Fax:360-272-1237
Practice Address - Street 1:308 W WILLOW CREEK DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-4814
Practice Address - Country:US
Practice Address - Phone:801-471-9314
Practice Address - Fax:360-272-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management