Provider Demographics
NPI:1083487995
Name:ABBIEBELLA SERVICES LLC
Entity Type:Organization
Organization Name:ABBIEBELLA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ETIDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPAN
Authorized Official - Suffix:
Authorized Official - Credentials:DBA (PHD)
Authorized Official - Phone:901-626-1083
Mailing Address - Street 1:9202 BEECH BEND TRL
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-2958
Mailing Address - Country:US
Mailing Address - Phone:901-626-1083
Mailing Address - Fax:
Practice Address - Street 1:9202 BEECH BEND TRL
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-2958
Practice Address - Country:US
Practice Address - Phone:901-626-1083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health