MEDICARE: ABBOTT COMMUNITY GROUP LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1467313312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBOTT COMMUNITY GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 667177
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77266-7177
Country	:	US
Telephone Number	:	832-955-8530
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	:	832-955-8530
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TABATHA SMITH
Credential	:
Telephone Number	:	832-955-8530

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	11/20/2025

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