Organization
ABIDING RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LA TONYA POLK (OWNER)
(903) 315-8302
Entity
Organization
Contact information
Practice address
205 E US HIGHWAY 80, WHITE OAK, TX 75693-2103
(903) 297-4959
(903) 297-4999
Mailing address
411 N FREDONIA ST STE 109, LONGVIEW, TX 75601-6467
(903) 234-8214
(903) 234-8138
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
143093
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001016175
—
TX
05
—
001019579
—
TX
05
—
001020325
—
TX
Enumeration date
04/05/2016
Last updated
04/05/2016
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