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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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