Organization
GREY PHOENIX LLC
Active
Parent organization
GREY PHOENIX LLC
Other names
Avender Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREY PHOENIX LLC
Authorized official
OLADIPUPO ADENUBI (MD/ CEO)
(202) 681-9190
Entity
Organization
Contact information
Practice address
2689 ORCHARD ORIOLE WAY, ODENTON, MD 21113-3120
(202) 681-9190
Mailing address
2689 ORCHARD ORIOLE WAY, ODENTON, MD 21113-3120
(202) 681-9190
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/24/2025
Last updated
05/02/2025
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