1336286061 NPI number — AMERICAN HABILITATION SERVICES, INC

Table of content: (NPI 1336286061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336286061 NPI number — AMERICAN HABILITATION SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HABILITATION SERVICES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336286061
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9050 N CAPITAL OF TEXAS HWY
Provider Second Line Business Mailing Address:
BUILDING 3-SUITE 130
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78759-7268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-236-1312
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 JUDSON RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LONGVIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75601-5192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-247-4876
Provider Business Practice Location Address Fax Number:
903-753-3484
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CLAPP
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
R
Authorized Official Title or Position:
SR. VICE PRESIDENT/CFO
Authorized Official Telephone Number:
512-236-1312

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000613200 . This is a "AB SA CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001015776 . This is a "BEAUMONT CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017085 . This is a "AUSTIN CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017094 . This is a "MIDLAND/ODESSA CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001012152 . This is a "HOUSTON CLAS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017087 . This is a "CORPUS CHRISTI CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017092 . This is a "LUBBOCK CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017090 . This is a "HOUSTON CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000602200 . This is a "AMARILLO CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000602300 . This is a "ODESSA CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000613400 . This is a "CORPUS CHRISTI CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017083 . This is a "ABILENE CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017091 . This is a "LONGVIEW CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017096 . This is a "SAN ANTONIO CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000614300 . This is a "LONGVIEW CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017089 . This is a "FORT WORTH CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000602400 . This is a "DALLAS CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000613500 . This is a "LUBBOCK CLASS DS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017084 . This is a "AMARILLO CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001017088 . This is a "DALLAS CLASS CM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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