Healthcare Provider Details

I. General information

NPI: 1568085132
Provider Name (Legal Business Name): ADAGE HEALTHCARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7404 EXECUTIVE PLACE SUITE 102
LANHAM MD
20706
US

IV. Provider business mailing address

7404 EXECUTIVE PL STE 102
LANHAM MD
20706-6230
US

V. Phone/Fax

Practice location:
  • Phone: 202-207-0726
  • Fax: 240-770-2421
Mailing address:
  • Phone: 240-206-8767
  • Fax: 240-245-3407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GRACE ADESANYA
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-918-7548