Provider Demographics
NPI:1811274053
Name:ABBEY CARE RESIDENTIAL HOMES
Entity type:Organization
Organization Name:ABBEY CARE RESIDENTIAL HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:HUNERYAGER
Authorized Official - Suffix:
Authorized Official - Credentials:CO-OWNER
Authorized Official - Phone:214-727-7533
Mailing Address - Street 1:7615 MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-4828
Mailing Address - Country:US
Mailing Address - Phone:214-727-7533
Mailing Address - Fax:
Practice Address - Street 1:7615 MEADOW RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-4828
Practice Address - Country:US
Practice Address - Phone:214-727-7533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132634305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132634OtherASSISTED LIVING HOME