Provider Demographics
NPI:1588275473
Name:AEDEL GLOBAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:AEDEL GLOBAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADENIYI
Authorized Official - Middle Name:OLUBUNMI
Authorized Official - Last Name:ADEOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-626-8800
Mailing Address - Street 1:2824 PINO
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-0108
Mailing Address - Country:US
Mailing Address - Phone:401-626-8800
Mailing Address - Fax:
Practice Address - Street 1:2824 PINO
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-0108
Practice Address - Country:US
Practice Address - Phone:401-626-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities