Healthcare Provider Details

I. General information

NPI: 1366245888
Provider Name (Legal Business Name): AD HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12541 PETREL XING
MIDLOTHIAN VA
23112-2955
US

IV. Provider business mailing address

12541 PETREL XING
MIDLOTHIAN VA
23112-2955
US

V. Phone/Fax

Practice location:
  • Phone: 804-252-3931
  • Fax:
Mailing address:
  • Phone: 804-252-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES OTERO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 804-252-3931