Provider Demographics
NPI:1669601217
Name:JY ADEKALE GLOBAL INITIATIVE
Entity type:Organization
Organization Name:JY ADEKALE GLOBAL INITIATIVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEBOWALE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEKALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-514-0921
Mailing Address - Street 1:4913 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-5309
Mailing Address - Country:US
Mailing Address - Phone:307-514-0921
Mailing Address - Fax:
Practice Address - Street 1:4913 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-5309
Practice Address - Country:US
Practice Address - Phone:307-514-0921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY127297700Medicaid