Abundant Hospice and Palliative Care Inc
Organization Active NPI Community Based Hospice Care Agency · Katy, TX
NPI 1356973101 · NPPES record last updated Feb 10, 2020
Key facts
- NPI
- 1356973101
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- ABUNDANT HOSPICE AND PALLIATIVE CARE INC
- Practice address
- 21627 Manitou Falls LN
Katy, TX 77449-4695 - Phone
- (832) 509-6853
- NPI assigned
- Feb 10, 2020
- Organization subpart
- No
Authorized official
- Name
- Agnes J Berry
- Title
- Ceo
- Phone
- (832) 509-6853
Medicare Care Compare: Hospice
- Listed as
- Abundant Hospice and Palliative Care
- Certified
- May 24, 2024
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Hospice certification: CCN A91730
- Legal name
- ABUNDANT HOSPICE AND PALLIATIVE CARE INC
- Doing business as
- ABUNDANT HOSPICE AND PALLIATIVE CARE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 24, 2024
- Last certification
- May 24, 2024
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 10, 2020 in TX
- Enrollment address
- 9100 Southwest Fwy
Ste 235
Houston, TX 77074-1519
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Agnes Berry |
Corporate Director |
Oct 1, 2023 | |
| Adonis Jay Adams |
5% Or Greater Direct Ownership Interest |
Feb 10, 2020 | 50% |
| Corporate Officer |
Feb 10, 2020 | 100% | |
| Corporate Director |
Feb 10, 2020 | 100% | |
| W-2 Managing Employee |
Aug 20, 2021 | 100% | |
| Sheila Renea Lawson |
5% Or Greater Direct Ownership Interest |
Feb 10, 2020 | 50% |
| Corporate Officer |
Aug 20, 2021 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211104000438 | TX | Part a Provider - Hospice | 0941698302 | Practice locations: Houston, TX |
National Provider Directory
Locations
9100 Southwest Fwy
Ste 235
Houston, TX 77074
Phone (800) 214-5806
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
21627 Manitou Falls LN
Katy, TX 77449-4695
Mailing address
21627 Manitou Falls LN
Katy, TX 77449-4695
Phone (832) 509-6853
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All providers in Katy, TX · Community Based Hospice Care Agency in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.