Provider Demographics
NPI:1669037172
Name:ADAM HOMES LLC
Entity Type:Organization
Organization Name:ADAM HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FERDUS
Authorized Official - Middle Name:YUSUF
Authorized Official - Last Name:AWALI
Authorized Official - Suffix:
Authorized Official - Credentials:RN/BSN
Authorized Official - Phone:207-344-9221
Mailing Address - Street 1:277 LISBON ST STE 9
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7368
Mailing Address - Country:US
Mailing Address - Phone:207-753-0774
Mailing Address - Fax:
Practice Address - Street 1:277 LISBON ST STE 9
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7368
Practice Address - Country:US
Practice Address - Phone:207-753-0774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health