Healthcare Provider Details

I. General information

NPI: 1902048606
Provider Name (Legal Business Name): ADOBE CASITA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 N CENTER ST SUITE #8
MESA AZ
85201-7304
US

IV. Provider business mailing address

12 N CENTER ST SUITE #8
MESA AZ
85201-7304
US

V. Phone/Fax

Practice location:
  • Phone: 480-610-2362
  • Fax: 480-258-6972
Mailing address:
  • Phone: 480-610-2362
  • Fax: 480-258-6972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier210056
Identifier TypeOTHER
Identifier StateAZ
Identifier IssuerARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

VIII. Authorized Official

Name: PATRICIA CELAYA
Title or Position: OWNER
Credential: R.N.
Phone: 480-610-2362