4Life Home Health Services LLC – Home Health Agency

Key facts

NPI: 1891487500
Entity type: Organization (NPI type 2)
Primary specialty: Home Health Agency 251E00000X
Legal business name: 4LIFE HOME HEALTH SERVICES LLC
Practice address: 1106 N State Highway 360 Ste 220
Grand Prairie, TX 75050-2511
Phone: (682) 321-7002
Fax: (682) 321-7028
NPI assigned: May 22, 2023
Organization subpart: No

Authorized official

Name: Adeleye Adekola
Title: Owner/President/Secretary
Phone: (347) 909-5884

Medicare Care Compare: Home health agency

Listed as: 4Life Home Health Services LLC CCN 748164
Ownership: -
Certified: Jun 13, 2025
Medicare certification status: Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
45D2302557	4Life Home Health Services LLC 1106 N State Hwy 360 Ste 220, Grand Prairie, TX 75050	Certificate of waiver	Apr 10, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in TX

Home health agency certification: CCN 748164

Legal name: 4LIFE HOME HEALTH SERVICES LLC
Certification status: Active
Provider type (POS): Home health agency
Participating since: Jun 13, 2025
Last certification: Jun 4, 2025
Organization structure: LLC · Proprietary
Enrollment address: 1106 N State Highway 360
Ste 220
Grand Prairie, TX 75050-2511

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Name	Role	Since	Share
Adeleye Adekola Individual	5% Or Greater Direct Ownership Interest Owner /President	May 4, 2023	90%
	Corporate Officer Owner /President	May 4, 2023	90%
	W-2 Managing Employee Owner /President	May 4, 2023	90%
Adetunji Adekola Individual	5% Or Greater Direct Ownership Interest Owner /Vice President	May 4, 2023	10%
	Corporate Officer Owner /Vice President	May 4, 2023	10%
	W-2 Managing Employee Owner / Vice President	May 4, 2023	10%

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20240823002334	TX	Part a Provider - Home Health Agency	2567901432	Practice locations: Grand Prairie, TX

National Provider Directory

Locations

2305 Oak Ln
Ste 103
Grand Prairie, TX 75051
Phone (469) 626-8195

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Health Agency	251E00000X			Yes
In Home Supportive Care Agency	253Z00000X

Addresses

Primary practice location

1106 N State Highway 360 Ste 220
Grand Prairie, TX 75050-2511

Mailing address

1106 N State Highway 360 Ste 220
Grand Prairie, TX 75050-2511
Phone (682) 321-7002

Other providers in Grand Prairie, TX

All providers in Grand Prairie, TX · Home Health Agency in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.