Provider Demographics
NPI:1427591361
Name:ABOVE AVERAGE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ABOVE AVERAGE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FARRAH
Authorized Official - Middle Name:ALECIA
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-944-8042
Mailing Address - Street 1:1931 GARNET BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1115
Mailing Address - Country:US
Mailing Address - Phone:832-964-3026
Mailing Address - Fax:832-442-4866
Practice Address - Street 1:1931 GARNET BREEZE DR
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-1115
Practice Address - Country:US
Practice Address - Phone:832-964-3026
Practice Address - Fax:832-442-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-26
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017727253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3747P1801XMedicaid
TX372500000XMedicaid
TX3747A0650XMedicaid
TX374U00000XMedicaid