Provider Demographics
NPI:1720445745
Name:ABUNDANT HABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:ABUNDANT HABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-893-1096
Mailing Address - Street 1:5211 88TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3513
Mailing Address - Country:US
Mailing Address - Phone:806-368-3857
Mailing Address - Fax:806-368-3857
Practice Address - Street 1:5211 88TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3513
Practice Address - Country:US
Practice Address - Phone:806-368-3857
Practice Address - Fax:806-368-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care