Healthcare Provider Details

I. General information

NPI: 1174155444
Provider Name (Legal Business Name): ABILENE HEALTHCARE OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 CLARKS DR
ABILENE TX
79602-3146
US

IV. Provider business mailing address

239 AVE ARTERIAL HOSTOS STE 606
SAN JUAN PR
00918-1347
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-9293
  • Fax:
Mailing address:
  • Phone: 787-232-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LLOYD DOUGLAS
Title or Position: MANAGER
Credential:
Phone: 787-232-0550