MEDICARE: JAMS RAL INVESTMENT 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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1396513644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMS RAL INVESTMENT LLC

Provider Business Mailing Address
First Line	:	7303 WHITMAN AVE
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98903-3206
Country	:	US
Telephone Number	:	509-480-2260
Fax Number	:

Provider Business Practice Location Address
First Line	:	7630 ROZA HILL DR
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-8031
Country	:	US
Telephone Number	:	509-480-2260
Fax Number	:

Authorized Official
Title or Position	:	ENTITY REPRESTENTATIVE
Name	:	AMBER PITTMON
Credential	:	RN
Telephone Number	:	509-480-2260

Provider Enumeration Date	:	12/15/2023
Last Update Date	:	12/15/2023

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