Provider Demographics
NPI:1063286896
Name:ADAM'S HOUSE INC
Entity type:Organization
Organization Name:ADAM'S HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STURGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-772-5849
Mailing Address - Street 1:11825 E MINGUS VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315-9717
Mailing Address - Country:US
Mailing Address - Phone:028-925-6673
Mailing Address - Fax:928-772-8308
Practice Address - Street 1:7697 E NIGHTINGALE STAR LN
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86315-3050
Practice Address - Country:US
Practice Address - Phone:928-925-6673
Practice Address - Fax:928-772-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances