Healthcare Provider Details

I. General information

NPI: 1003753773
Provider Name (Legal Business Name): EVERGROVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17325 EUCLID AVE STE 3027
CLEVELAND OH
44112-1276
US

IV. Provider business mailing address

17325 EUCLID AVE STE 3027
CLEVELAND OH
44112-1276
US

V. Phone/Fax

Practice location:
  • Phone: 202-656-0380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AHMED ADAN
Title or Position: CEO
Credential:
Phone: 614-260-7760