Provider Demographics
NPI:1003310038
Name:ABW SOUTHERN LLC
Entity Type:Organization
Organization Name:ABW SOUTHERN LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THURSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-816-6000
Mailing Address - Street 1:10 VAUGHAN MALL STE 209
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4068
Mailing Address - Country:US
Mailing Address - Phone:603-816-6000
Mailing Address - Fax:603-433-5655
Practice Address - Street 1:70 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-816-6000
Practice Address - Fax:603-433-5655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A BETTER WAY FOR SENIORS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-23
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03237251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE