Organization
FADMO HEALTH AND HOME CARE AGENCY INC
Active
Other names
FADMO HEALTH AND ALLIED SCHOOL
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY AGBOOLA CNM (CEO)
(718) 390-0561
Entity
Organization
Contact information
Practice address
194 TARGEE ST, STATEN ISLAND, NY 10304-1926
(718) 390-0561
(718) 390-5166
Mailing address
194 TARGEE ST, ABBY AGBOOLA, STATEN ISLAND, NY 10304-1926
(718) 390-0561
(718) 390-5166
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
403674-1
NY
251F00000X
Home Infusion Agency
Primary
—
—
251J00000X
Nursing Care Agency
403674-1
NY
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
360383-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1343L001
CLIA WAIVER
NY
05
—
1343L001
—
NY
Enumeration date
12/30/2006
Last updated
03/05/2021
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