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NPI Code Detail

MEDICARE: ADULT ULTIMATE DAYCARE CENTER, INC.

MEDICARE: ADULT ULTIMATE DAYCARE CENTER, INC.
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
1261QA0600XAdult Day Care Clinic/Center
2373H00000XDay Training/Habilitation Specialist119453TX
3373H00000XDay Training/Habilitation Specialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275662827
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADULT ULTIMATE DAYCARE CENTER, INC.
Provider Business Mailing Address
First Line : 3650 N BUCKNER BLVD SUITE 110A
Second Line :
City : DALLAS
State : TX
Zip : 75228-5652
Country : US
Telephone Number : 214-320-0080
Fax Number : 214-320-0087
Provider Business Practice Location Address
First Line : 3650 N BUCKNER BLVD SUITE 110A
Second Line :
City : DALLAS
State : TX
Zip : 75228-5652
Country : US
Telephone Number : 214-320-0080
Fax Number : 214-320-0087
Authorized Official
Title or Position : OWNER
Name : MRS. SHERRI ABIOLA ABU
Credential : RN
Telephone Number : 214-320-0080
Provider Enumeration Date : 03/02/2007
Last Update Date : 06/24/2019

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Directions to “ADULT ULTIMATE DAYCARE CENTER, INC. ” Practice Location

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