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NPI Code Detail

MEDICARE: ADORA HEALTHCARE SERVICES

MEDICARE: ADORA HEALTHCARE SERVICES
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3103TP2701XGroup Psychotherapy Psychologist
4363LP0808XPsychiatric/Mental Health Nurse Practitioner
5320800000XMental Illness Community Based Residential Treatment Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972195428
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADORA HEALTHCARE SERVICES
Provider Business Mailing Address
First Line : 3045 E CHOLLA ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-1917
Country : US
Telephone Number : 216-544-5418
Fax Number : 623-251-7452
Provider Business Practice Location Address
First Line : 3045 E CHOLLA ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-1917
Country : US
Telephone Number : 216-544-5418
Fax Number : 623-251-7452
Authorized Official
Title or Position : CEO
Name : PETER TAMUNOH TEBOH
Credential : FNP-BC
Telephone Number : 216-544-5418
Provider Enumeration Date : 02/05/2021
Last Update Date : 02/05/2021

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Directions to “ADORA HEALTHCARE SERVICES ” Practice Location

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