Healthcare Provider Details

I. General information

NPI: 1275662827
Provider Name (Legal Business Name): ADULT ULTIMATE DAYCARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 N BUCKNER BLVD SUITE 110A
DALLAS TX
75228-5652
US

IV. Provider business mailing address

3650 N BUCKNER BLVD SUITE 110A
DALLAS TX
75228-5652
US

V. Phone/Fax

Practice location:
  • Phone: 214-320-0080
  • Fax: 214-320-0087
Mailing address:
  • Phone: 214-320-0080
  • Fax: 214-320-0087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number119453
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHERRI ABIOLA ABU
Title or Position: OWNER
Credential: RN
Phone: 214-320-0080