MEDICARE: ADOBE CARE AND WELLNESS LOUISIANA 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1972367431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADOBE CARE AND WELLNESS LOUISIANA LLC

Provider Business Mailing Address
First Line	:	7500 N DREAMY DRAW DR STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4668
Country	:	US
Telephone Number	:	520-233-7111
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 N DREAMY DRAW DR STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4668
Country	:	US
Telephone Number	:	520-233-7111
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JAYME AMBROSE
Credential	:
Telephone Number	:	520-233-7111

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	02/06/2024

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