Healthcare Provider Details

I. General information

NPI: 1013283571
Provider Name (Legal Business Name): ABOL CARE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17730 SCARLETT FALLS LN
RICHMOND TX
77407-2155
US

IV. Provider business mailing address

17730 SCARLETT FALL LN
RICHMOND TX
77407
US

V. Phone/Fax

Practice location:
  • Phone: 832-757-9488
  • Fax:
Mailing address:
  • Phone: 832-757-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number0000000
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BILIKISU ADEBOLO ANDREWS
Title or Position: PROGRAM MANAGER
Credential:
Phone: 832-757-9488