Healthcare Provider Details
I. General information
NPI: 1336286061
Provider Name (Legal Business Name): AMERICAN HABILITATION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2007
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1125 JUDSON RD SUITE 100
LONGVIEW TX
75601-5192
US
IV. Provider business mailing address
9050 N CAPITAL OF TEXAS HWY BUILDING 3-SUITE 130
AUSTIN TX
78759-7268
US
V. Phone/Fax
- Phone: 903-247-4876
- Fax: 903-753-3484
- Phone: 512-236-1312
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DENNIS
R
CLAPP
Title or Position: SR. VICE PRESIDENT/CFO
Credential:
Phone: 512-236-1312