Provider Demographics
NPI:1083392583
Name:BA1A LLC
Entity Type:Organization
Organization Name:BA1A LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALGHABRA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:571-752-2991
Mailing Address - Street 1:11906 ZIYAD DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8585
Mailing Address - Country:US
Mailing Address - Phone:248-802-5480
Mailing Address - Fax:
Practice Address - Street 1:500 WESTWOOD OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5112
Practice Address - Country:US
Practice Address - Phone:571-752-2991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care