Provider Demographics
NPI:1134400351
Name:ADONAI SERVICES
Entity type:Organization
Organization Name:ADONAI SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DYLEANE
Authorized Official - Middle Name:HOOKER
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-508-9306
Mailing Address - Street 1:109 SOUTH CAMILIA BOULEVARD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT VALLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31030
Mailing Address - Country:US
Mailing Address - Phone:478-825-8600
Mailing Address - Fax:
Practice Address - Street 1:109 S CAMELLIA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:GA
Practice Address - Zip Code:31030-3702
Practice Address - Country:US
Practice Address - Phone:478-825-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care