Provider Demographics
NPI:1750887071
Name:ABIDING LOVE INTERNATIONAL FELLOWSHIP
Entity type:Organization
Organization Name:ABIDING LOVE INTERNATIONAL FELLOWSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEKEMI
Authorized Official - Middle Name:OLUBUKOLA
Authorized Official - Last Name:BANKOLE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:609-273-4651
Mailing Address - Street 1:210 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-1910
Mailing Address - Country:US
Mailing Address - Phone:609-392-0032
Mailing Address - Fax:609-530-1348
Practice Address - Street 1:210 GENESEE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-1910
Practice Address - Country:US
Practice Address - Phone:609-392-0032
Practice Address - Fax:609-530-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty