NPIMap

Organization Active NPI

Abiding Residential Services

  • Assisted Living Facility
  • White Oak, TX
National Provider Identifier
1093179145
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
143093 Issued in TX
Legal business name
ABIDING RESIDENTIAL SERVICES
Practice address
205 E US Highway 80
White Oak, TX 75693-2103
Phone
(903) 297-4959
Fax
(903) 297-4999
NPI assigned
Apr 5, 2016
Last updated
Apr 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. La Tonya PolkNPI 1861551814
Title
Owner
Phone
(903) 315-8302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 143093 TX Primary

Addresses

Primary practice location

205 E US Highway 80
White Oak, TX 75693-2103

Mailing address

411 N Fredonia St Ste 109
Longview, TX 75601-6467
Phone (903) 234-8214

Other identifiers 3

IdentifierTypeStateIssuer
001016175MedicaidTX
001019579MedicaidTX
001020325MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1093179145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N FREDONIA ST STE 109",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016467",
            "telephone_number": "903-234-8214",
            "fax_number": "903-234-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E US HIGHWAY 80",
            "city": "WHITE OAK",
            "state": "TX",
            "postal_code": "756932103",
            "telephone_number": "903-297-4959",
            "fax_number": "903-297-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABIDING RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "LA TONYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-315-8302",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "143093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001016175",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019579",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020325",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.