MEDICARE: R&A ADULT CARE SERVICES,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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1760869507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R&A ADULT CARE SERVICES,LLC

Provider Business Mailing Address
First Line	:	1111 E I65 SERVICE RD S
Second Line	:	SUITE A2
City	:	MOBILE
State	:	AL
Zip	:	36606-3112
Country	:	US
Telephone Number	:	251-298-0232
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 E I65 SERVICE RD S
Second Line	:	SUITE A2
City	:	MOBILE
State	:	AL
Zip	:	36606-3112
Country	:	US
Telephone Number	:	251-298-0232
Fax Number	:

Authorized Official
Title or Position	:	CNA/OWNER
Name	:	MS. RODERICA BRAXTON-GREEN
Credential	:	CNA
Telephone Number	:	251-298-0232

Provider Enumeration Date	:	04/30/2015
Last Update Date	:	04/30/2015

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