Healthcare Provider Details

I. General information

NPI: 1861073868
Provider Name (Legal Business Name): ADAIR HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 SHERIFF RD NE
WASHINGTON DC
20019-4802
US

IV. Provider business mailing address

4905 SHERIFF RD NE
WASHINGTON DC
20019-4802
US

V. Phone/Fax

Practice location:
  • Phone: 443-678-9000
  • Fax:
Mailing address:
  • Phone: 443-678-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DARYL L ADAIR
Title or Position: PRESIDENT
Credential:
Phone: 202-369-1634