Provider Demographics
NPI:1942727805
Name:ADASSAH HEALTH RESOURCES, LLC
Entity Type:Organization
Organization Name:ADASSAH HEALTH RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLABODE
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:LONGE
Authorized Official - Suffix:
Authorized Official - Credentials:BSC, FCA, CISA
Authorized Official - Phone:443-226-3289
Mailing Address - Street 1:9721 LUGUNA RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-3769
Mailing Address - Country:US
Mailing Address - Phone:443-226-3289
Mailing Address - Fax:410-510-1182
Practice Address - Street 1:9721 LUGUNA RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-3769
Practice Address - Country:US
Practice Address - Phone:443-226-3289
Practice Address - Fax:410-510-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MDR4058364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty