Healthcare Provider Details

I. General information

NPI: 1609702414
Provider Name (Legal Business Name): PATRICIA A ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALBERT D BLACK STNA

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4941 BECKER DR
DAYTON OH
45417-9121
US

IV. Provider business mailing address

4941 BECKER DR
DAYTON OH
45417-9121
US

V. Phone/Fax

Practice location:
  • Phone: 937-203-7512
  • Fax:
Mailing address:
  • Phone: 937-889-5898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: