MEDICARE: ADEQUATE HEALTHCARE LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1942812441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADEQUATE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4301 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2600
Country	:	US
Telephone Number	:	240-554-7792
Fax Number	:	877-775-6657

Provider Business Practice Location Address
First Line	:	4301 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2600
Country	:	US
Telephone Number	:	877-707-7790
Fax Number	:	877-775-6657

Authorized Official
Title or Position	:	OWNER
Name	:	VERA NGEZEM
Credential	:	NP
Telephone Number	:	877-707-7790

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	11/23/2022

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