Provider Demographics
NPI:1811734692
Name:ADULTGERO HEALTH PLLC
Entity type:Organization
Organization Name:ADULTGERO HEALTH PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANA YAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDAI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:614-300-8971
Mailing Address - Street 1:6470 ROGERS RD UNIT 244
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-2011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:430 W GATE CITY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-1262
Practice Address - Country:US
Practice Address - Phone:614-300-8971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251300000XAgenciesLocal Education Agency (LEA)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center