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General NPI Number Information
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NPI Number | 1740068410
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Entity Type | Organization
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Legal Business Name | ABIDING LIGHT HOMECARE
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 16225 PARK TEN PL STE 500
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City | HOUSTON
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State | TX
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Zip | 77084-5152
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Country | US
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Telephone | 512-850-6818
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Fax |
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Provider Business Mailing Address
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Address Line | 16225 PARK TEN PL STE 500
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City | HOUSTON
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State | TX
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Zip | 77084-5152
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Country | US
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Telephone | 512-850-6818
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | SHANILLE CLARKE DAVIS
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Credential | RN, COTA
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Telephone | 512-850-6818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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