Provider Demographics
NPI:1356308886
Name:ABUNDANT HEALTH CARE INC
Entity Type:Organization
Organization Name:ABUNDANT HEALTH CARE INC
Other - Org Name:ABUNDANT HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:956-631-0012
Mailing Address - Street 1:1305 E NOLANA AVE
Mailing Address - Street 2:SUITE B &C
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-631-0012
Mailing Address - Fax:956-631-0054
Practice Address - Street 1:1305 E NOLANA AVE
Practice Address - Street 2:SUITE B &C
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-631-0012
Practice Address - Fax:956-631-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007025251E00000X
TX007268251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000110200OtherPRIMARY HOME CARE
TX024347901Medicaid
TX000959000OtherCOMMUNITYBASED ALTERNATIV
TX000110200OtherPRIMARY HOME CARE