MEDICARE: ABODE SERVICES

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1356737951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABODE SERVICES

Provider Business Mailing Address
First Line	:	40849 FREMONT BLVD
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-4306
Country	:	US
Telephone Number	:	510-657-7409
Fax Number	:	510-270-3259

Provider Business Practice Location Address
First Line	:	701 CURTNER AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-2037
Country	:	US
Telephone Number	:	510-657-7409
Fax Number	:	510-270-3259

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LOUIS CHICOINE
Credential	:
Telephone Number	:	510-657-7409

Provider Enumeration Date	:	04/09/2015
Last Update Date	:	04/09/2015

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