Basic Information
| Provider Information | |||||||||
| NPI: | 1710334974 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRACARE OF ABILENE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 4060 | ||||||||
| Address2: | ATTN: REGULATORY | ||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281171157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046620416 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4400 BUFFALO GAP RD STE 2400 | ||||||||
| Address2: | |||||||||
| City: | ABILENE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 796062701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256951962 | ||||||||
| FaxNumber: | 3256950225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2016 | ||||||||
| LastUpdateDate: | 10/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | COMBS | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP LICENSURE | ||||||||
| AuthorizedOfficialTelephone: | 9138142013 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | II | ||||||||
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| NPICertificationDate: | 10/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.