Healthcare Provider Details

I. General information

NPI: 1437284502
Provider Name (Legal Business Name): ABBACARE HOME HEALTH INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 UPTOWN BLVD STE 2000
CEDAR HILL TX
75104-3528
US

IV. Provider business mailing address

610 UPTOWN BLVD STE 2000
CEDAR HILL TX
75104-3528
US

V. Phone/Fax

Practice location:
  • Phone: 469-523-1373
  • Fax: 469-523-1374
Mailing address:
  • Phone: 469-523-1373
  • Fax: 469-523-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number012455
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number012455
License Number StateTX

VIII. Authorized Official

Name: DR. ROFINA ANOSIKE
Title or Position: OWNER
Credential: RPH,PHARMD
Phone: 469-523-1373