Provider Demographics
NPI:1194477992
Name:ADELLIET HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ADELLIET HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILLIET
Authorized Official - Middle Name:NGWEBENG
Authorized Official - Last Name:MUBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-768-1010
Mailing Address - Street 1:4243 WHITE CAP CRST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3256
Mailing Address - Country:US
Mailing Address - Phone:757-905-7314
Mailing Address - Fax:
Practice Address - Street 1:4243 WHITE CAP CRST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3256
Practice Address - Country:US
Practice Address - Phone:757-905-7314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty