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General NPI Number Information
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NPI Number | 1164428702
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Entity Type | Organization
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Legal Business Name | ABI CARE HOME HEALTH, LLC
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 2974 LBJ FWY SUITE 401
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City | DALLAS
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State | TX
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Zip | 75234-7602
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Country | US
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Telephone | 972-241-2419
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Fax |
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Provider Business Mailing Address
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Address Line | 2974 LBJ FWY SUITE 401
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City | DALLAS
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State | TX
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Zip | 75234-7602
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Country | US
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Telephone | 972-241-2419
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | OLATUNBOSUN OLUSEGUN OSUKOYA
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Credential |
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Telephone | 972-241-2419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 004704
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License Number State | TX
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