Provider Demographics
NPI:1558669630
Name:AJOOBA' CARE PARTNERS, INC.
Entity Type:Organization
Organization Name:AJOOBA' CARE PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLAW
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:928-714-8495
Mailing Address - Street 1:PO BOX 3994
Mailing Address - Street 2:
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503-3994
Mailing Address - Country:US
Mailing Address - Phone:928-714-8495
Mailing Address - Fax:
Practice Address - Street 1:GORMAN'S TRAILER COURT S1
Practice Address - Street 2:HIGHWAY 191
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503
Practice Address - Country:US
Practice Address - Phone:928-714-8495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ509075253Z00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ509075Medicaid