MEDICARE: ADOBE HOMECARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		TX

General Provider Information

NPI Number	:	1114242765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADOBE HOMECARE, INC

Provider Business Mailing Address
First Line	:	2105 DICIEMBRE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-2603
Country	:	US
Telephone Number	:	915-633-1868
Fax Number	:	915-633-1870

Provider Business Practice Location Address
First Line	:	2105 DICIEMBRE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-2603
Country	:	US
Telephone Number	:	915-633-1868
Fax Number	:	915-633-1870

Authorized Official
Title or Position	:	ADMINISTRATOR/SUPERVISING NURSE
Name	:	MARIA DEL CARMEN HERNANDEZ
Credential	:	RN
Telephone Number	:	915-276-8433

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	04/06/2010

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