Healthcare Provider Details

I. General information

NPI: 1114846508
Provider Name (Legal Business Name): AYA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 4284
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 4284
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 410-916-8857
  • Fax:
Mailing address:
  • Phone: 410-916-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA ADDO
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA, MSF
Phone: 410-916-8857