Provider Demographics
NPI:1710216270
Name:A & D SERVICES
Entity Type:Organization
Organization Name:A & D SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEWALE
Authorized Official - Middle Name:O
Authorized Official - Last Name:FAJEWONYOMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-434-5512
Mailing Address - Street 1:582 W VALLEY BLVD
Mailing Address - Street 2:12
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2273
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:582 W VALLEY BLVD
Practice Address - Street 2:12
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-2273
Practice Address - Country:US
Practice Address - Phone:909-434-5512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-12
Last Update Date:2009-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health