MEDICARE: ANCHOR 180 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	:	1780472027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHOR 180 LLC

Provider Business Mailing Address
First Line	:	708 MAIN ST FL 10
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-3246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 MAIN ST 10TH FLOOR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002
Country	:	US
Telephone Number	:	832-610-0040
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERRANCE TILLISON
Credential	:
Telephone Number	:	202-880-4987

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	12/08/2025

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Directions to “ANCHOR 180 LLC ” Practice Location

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