Individual
MEDETINA ADAGBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4900 GRANBY ST, DENVER, CO 80239-4267
(720) 728-9327
Mailing address
9748 DANUBE CT, COMMERCE CITY, CO 80022-2415
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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