Provider Demographics
NPI:1194314583
Name:ADAS-ADAMA DEVELOPMENTAL ASSISTANCE & SUPPORT LLC
Entity type:Organization
Organization Name:ADAS-ADAMA DEVELOPMENTAL ASSISTANCE & SUPPORT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:602-829-0907
Mailing Address - Street 1:9304 W OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3343
Mailing Address - Country:US
Mailing Address - Phone:602-900-3037
Mailing Address - Fax:
Practice Address - Street 1:9304 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3343
Practice Address - Country:US
Practice Address - Phone:602-829-0907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness