MEDICARE: ADULTOS HOME HEALTH CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1407097314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULTOS HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	415 DORADO CT SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-3743
Country	:	US
Telephone Number	:	505-332-3581
Fax Number	:	505-332-3581

Provider Business Practice Location Address
First Line	:	415 DORADO CT SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-3743
Country	:	US
Telephone Number	:	505-332-3581
Fax Number	:	505-332-3581

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALBERTO CANCIO
Credential	:
Telephone Number	:	505-332-3581

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	04/30/2009

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