=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780720508
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALBERTSON HEALTHCARE SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2007
-----------------------------------------------------
Last Update Date | 12/02/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6105 BEVERLYHILL ST STE 101
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77057-6716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-779-5200
-----------------------------------------------------
Fax | 713-779-5202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6105 BEVERLYHILL ST STE 101
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77057-6716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-779-5200
-----------------------------------------------------
Fax | 713-779-5202
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | C.E.O
-----------------------------------------------------
Name | MR. KAZI N HOSSAIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-779-5200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 011657
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------