| Abundant Care Services Llc | |
|
1100 Maxfield St Waco TX 76705-2967 | |
| (254) 644-7284 | |
| Not Available |
| Full Name | Abundant Care Services Llc |
|---|---|
| Speciality | Case Management |
| Location | 1100 Maxfield St, Waco, Texas |
| Authorized Official Name and Position | Hezborn Obat (CEO) |
| Authorized Official Contact | 2546447284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Care Services Llc 297 Lcr 114 Axtell TX 76624-1333 Ph: (254) 644-7284 | Abundant Care Services Llc 1100 Maxfield St Waco TX 76705-2967 Ph: (254) 644-7284 |
| NPI Number | 1366081812 |
|---|---|
| Provider Enumeration Date | 01/02/2020 |
| Last Update Date | 07/03/2024 |
| Certification Date | 06/11/2024 |
| Medicare PECOS PAC ID | 6002272028 |
|---|---|
| Medicare Enrollment ID | O20240201004534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366081812 | NPI | - | NPPES |
| Provider Name | Liliana Gamino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669990537 PECOS PAC ID: 4587923297 Enrollment ID: I20180125000577 |
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