MEDICARE: ABBY & ANTONIO INC., ACCLAIM CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	1020	VA

General Provider Information

NPI Number	:	1124221908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBY & ANTONIO INC., ACCLAIM CARE INC.

Provider Business Mailing Address
First Line	:	2915 HUNGARY RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 MILL RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23231-8017
Country	:	US
Telephone Number	:	804-795-2103
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. ANTONIO ALLEN SR.
Credential	:
Telephone Number	:	804-304-7010

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	08/22/2020

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