MEDICARE: ABOVE ALL OTHERS CARE HOME, 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1871937292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE ALL OTHERS CARE HOME, LLC

Provider Business Mailing Address
First Line	:	200 DOMINION PARK DR APT 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-6724
Country	:	US
Telephone Number	:	832-643-8266
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 DOMINION PARK DR APT 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-6724
Country	:	US
Telephone Number	:	832-643-8266
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	PAMELA D WOODS
Credential	:
Telephone Number	:	832-643-8266

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	04/29/2013

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