1336286061 NPI number — AMERICAN HABILITATION SERVICES, INC

Table of Contents

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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