Provider Demographics
NPI:1043560444
Name:ABBA HOME CARE LLC
Entity Type:Organization
Organization Name:ABBA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AKOSUA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWABIAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-822-4431
Mailing Address - Street 1:13928 JEFFERSON DAVIS HWY #C
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191
Mailing Address - Country:US
Mailing Address - Phone:703-822-4431
Mailing Address - Fax:
Practice Address - Street 1:13928 JEFFERSON DAVIS HWY #C
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:703-822-4431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health