MEDICARE: ABBOT GROUP 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1376874552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBOT GROUP INC.

Provider Business Mailing Address
First Line	:	15323 ALTA MESA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1348
Country	:	US
Telephone Number	:	832-598-2757
Fax Number	:

Provider Business Practice Location Address
First Line	:	15323 ALTA MESA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1348
Country	:	US
Telephone Number	:	832-598-2757
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. TABATHA SMITH
Credential	:
Telephone Number	:	832-598-2757

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	01/27/2010

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