1295060143 NPI number — ABUNDANT HOSPICE SERVICES, LLC

Table of content: (NPI 1295060143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295060143 NPI number — ABUNDANT HOSPICE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABUNDANT HOSPICE SERVICES, LLC
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:
6
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:
1295060143
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 N WATSON RD STE 166
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76006-6223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-633-8300
Provider Business Mailing Address Fax Number:
817-633-8302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 N WATSON RD
Provider Second Line Business Practice Location Address:
SUITE 166
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76006-6222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-633-8300
Provider Business Practice Location Address Fax Number:
817-633-8302
Provider Enumeration Date:
10/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LANE
Authorized Official First Name:
MARI-TONI
Authorized Official Middle Name:
CARAG
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
817-633-8300

Provider Taxonomy Codes

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

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

  • Identifier: 67-1668 . This is a "PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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