Provider Demographics
NPI:1104989565
Name:ABUNDANT CARE CENTER, INC.
Entity type:Organization
Organization Name:ABUNDANT CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ABAYOMI
Authorized Official - Last Name:OGUNNAIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-498-2370
Mailing Address - Street 1:12100 S HIGHWAY 6
Mailing Address - Street 2:8109
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5712
Mailing Address - Country:US
Mailing Address - Phone:281-498-2370
Mailing Address - Fax:281-498-2370
Practice Address - Street 1:12100 S HIGHWAY 6
Practice Address - Street 2:8109
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5712
Practice Address - Country:US
Practice Address - Phone:281-498-2370
Practice Address - Fax:281-498-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities