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NPI Code Detail

MEDICARE: ABODE SERVICES

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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1619710910
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 1840 CAPITOL ST STE A
Second Line :
City : VALLEJO
State : CA
Zip : 94590-5721
Country : US
Telephone Number : 510-657-7409
Fax Number :
Authorized Official
Title or Position : QUALITY ASSURANCE COORDINATOR
Name : SHERMAN WONG
Credential :
Telephone Number : 510-270-1150
Provider Enumeration Date : 06/14/2024
Last Update Date : 06/14/2024

Similar Medicare Providers

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1699486779 — LAUREN KOENIGSHOFER
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Directions to “ABODE SERVICES ” Practice Location

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