Jeffrey Chonaworah Adisam

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1851831911

Jeffrey Chonaworah Adisam is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Giddings, Texas. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since: 2017

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Practice location Address checks out

1087 E Independence St 306
Giddings, TX 78942-1434
Phone: (720) 277-7404

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Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary)	Taxonomy 320900000X

Record details

NPI number	1851831911
Entity type	Individual (Type 1)
Gender	Male
Sole proprietor	Yes
NPI enumerated	March 8, 2017
Last updated in NPPES	March 8, 2017