Adisam, Jeffrey Chonaworah

Adisam, Jeffrey Chonaworah is an sole proprietor health care provider with primary practice located at 1087 E Independence St 306, Giddings TX 78942-1434. He recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as his primary health care specialty. Adisam, Jeffrey Chonaworah can be contacted via phone (720) 277-7404.

Contact Information

Primary practice address
1087 E Independence St 306 Giddings TX 78942-1434
Phone: (720) 277-7404
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1851831911
LBN Legal business name Adisam, Jeffrey Chonaworah
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 8th, 2017
Last updated Mar 8th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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