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General NPI Number Information
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NPI Number | 1073816724
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Entity Type | Organization
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Legal Business Name | ABIGAIL'S CARE CENTER,LLC
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 7506 CYPRESS BLUFF DR
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City | CYPRESS
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State | TX
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Zip | 77433-1725
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Country | US
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Telephone | 281-467-9043
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Fax |
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Provider Business Mailing Address
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Address Line | 7506 CYPRESS BLUFF DR
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City | CYPRESS
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State | TX
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Zip | 77433-1725
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Country | US
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Telephone | 281-467-9043
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SUBE MOMODU
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Credential | REGISTERED NURSE
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Telephone | 281-467-9043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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