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General NPI Number Information
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NPI Number | 1639525397
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Entity Type | Organization
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Legal Business Name | ADAM MC CARE LLC
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 801 RUSTY BUCKET CT
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City | EL PASO
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State | TX
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Zip | 79932-4007
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Country | US
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Telephone | 915-540-6865
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Fax |
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Provider Business Mailing Address
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Address Line | 801 RUSTY BUCKET CT
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City | EL PASO
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State | TX
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Zip | 79932-4007
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Country | US
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Telephone | 915-540-6865
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | ROSA CISNEROS
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Credential | ACCOUNTANT
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Telephone | 915-540-6865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 142685
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License Number State | TX
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