Healthcare Provider Details
I. General information
NPI: 1114170453
Provider Name (Legal Business Name): AB INNOVATIONS HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2008
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
508 S JEFFERSON AVE
MT PLEASANT TX
75455-4881
US
IV. Provider business mailing address
400 INTERSTATE NORTH PKWY SE STE 1600
ATLANTA GA
30339-5047
US
V. Phone/Fax
- Phone: 430-222-0079
- Fax: 903-717-3102
- Phone: 770-248-8740
- Fax: 770-248-8192
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
BUCKHALTER
Title or Position: CFO
Credential:
Phone: 470-464-8000