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Organization

PELUMI BADMUS INS. AGENCY, LLC

Active
Parent organization
HERO'S SHELTER, INC.
Other names
VOGUE ASSURANCE
Organization subpart
Yes

Provider details

NPI number
Legal business name
HERO'S SHELTER, INC.
Authorized official
MS. OLUWAPELUMI OLUKOTUN BSN, MSHA, APRN, CCM (CERTIFIED CASE MANAGER)
(571) 400-8461
Entity
Organization

Contact information

Practice address
155 L STREET, NW, ( R.H TERRELL RECREATION CENTER), WASHINGTON, DC 20001
(571) 400-8461
Mailing address
PO BOX 558, SAN LUIS REY, CA 92068-0558
(571) 400-8461

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
4217575
251B00000X
Case Management Agency
4217575
251E00000X
Home Health Agency
251T00000X
PACE Provider Organization
4217575
251X00000X
Supports Brokerage Agency
Primary
252Y00000X
Early Intervention Provider Agency
4217575
261QH0100X
Health Service Clinic/Center
305S00000X
Point of Service
4217575
332B00000X
Durable Medical Equipment & Medical Supplies
4217575
347C00000X
Private Vehicle
4217575

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
999999999999
AL
05
999999999999
CA
05
999999999999
CO
05
999999999999
DC
05
999999999999
DE
05
999999999999
FL
05
999999999999
GA
05
999999999999
LA
05
999999999999
MD
05
999999999999
NC
05
999999999999
NY
05
999999999999
TX
05
999999999999
VA
Enumeration date
03/25/2017
Last updated
08/13/2020
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