Individual provider · NPI-1

Medetina Adagba

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Denver, CO

NPI number1932924487

StatusActive

Last updated in NPPESNov 20, 2024

Details

NPI: 1932924487
Entity type: Individual (NPI-1)
Name: Medetina Adagba
Sex: Female
Sole proprietor: Yes
Enumeration date: Nov 20, 2024
Certification date: Oct 29, 2024
Last updated: Nov 20, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–	Yes
253Z00000X	In Home Supportive Care	–	–
385HR2060X	Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child	–	–

Practice location

4900 Granby St
Denver, CO 80239-4267

Phone 720-728-9327

Mailing address

9748 Danube Ct
Commerce City, CO 80022-2415

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