MEDICARE: ADAMAS INDUSTRIES, LLC

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1215507199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAMAS INDUSTRIES, LLC

Provider Business Mailing Address
First Line	:	1020 N WOODLAND AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-7308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 N WOODLAND AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-7308
Country	:	US
Telephone Number	:	520-777-3198
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARA RUSSO
Credential	:
Telephone Number	:	520-777-3198

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	08/02/2021

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Directions to “ADAMAS INDUSTRIES, LLC ” Practice Location

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