MEDICARE: TERRAGRADE HEALTH CARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1386086015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRAGRADE HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	9420 ANNAPOLIS RD
Second Line	:	212
City	:	LANHAM
State	:	MD
Zip	:	20706-3021
Country	:	US
Telephone Number	:	301-440-6002
Fax Number	:

Provider Business Practice Location Address
First Line	:	9420 ANNAPOLIS RD
Second Line	:	212
City	:	LANHAM
State	:	MD
Zip	:	20706-3021
Country	:	US
Telephone Number	:	301-440-6002
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABAYOMI MICHEAL SOKOYA
Credential	:
Telephone Number	:	301-440-6002

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	07/23/2013

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