Healthcare Provider Details

I. General information

NPI: 1730023292
Provider Name (Legal Business Name): ACCESS MOBILE CARE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 WOODSMOKE LN
ROCHESTER NY
14612-1630
US

IV. Provider business mailing address

64 WOODSMOKE LN
ROCHESTER NY
14612-1630
US

V. Phone/Fax

Practice location:
  • Phone: 585-210-3483
  • Fax:
Mailing address:
  • Phone: 585-210-3483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADELE KIBASUMBA
Title or Position: NURSE PRACTICTIONER
Credential: NP-C
Phone: 585-210-3483