Provider Demographics
NPI:1972880805
Name:ABC SENIOR SOLUTIONS
Entity Type:Organization
Organization Name:ABC SENIOR SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-533-5743
Mailing Address - Street 1:120 S DENTON TAP RD STE 450
Mailing Address - Street 2:PMB 174
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5049
Mailing Address - Country:US
Mailing Address - Phone:855-533-8688
Mailing Address - Fax:866-243-8902
Practice Address - Street 1:120 S DENTON TAP RD STE 450
Practice Address - Street 2:PMB 174
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5049
Practice Address - Country:US
Practice Address - Phone:855-533-8688
Practice Address - Fax:866-243-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty