Provider Demographics
NPI:1083794093
Name:ABS LINCS VA
Entity Type:Organization
Organization Name:ABS LINCS VA
Other - Org Name:FIRST HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:1634 LONDON BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2137
Mailing Address - Country:US
Mailing Address - Phone:757-393-7211
Mailing Address - Fax:757-393-7219
Practice Address - Street 1:1634 LONDON BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2137
Practice Address - Country:US
Practice Address - Phone:757-393-7211
Practice Address - Fax:757-393-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACO-09-06101YP2500X, 103TC0700X, 1041C0700X
VACO-90-06171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010239842Medicaid
DC055924Medicaid
VA010023084Medicaid
VA000200140Medicaid
VA000200565Medicaid
VA4941373Medicaid
VA000200158Medicaid
VA010012317Medicaid
VA4941365Medicaid
VA4941381Medicaid