Provider Demographics
NPI:1225811185
Name:ABIEN IN HOME SUPPORT INC
Entity Type:Organization
Organization Name:ABIEN IN HOME SUPPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELENOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:EBENKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-200-3314
Mailing Address - Street 1:14904 RICHMOND HWY STE 411
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14904 RICHMOND HWY STE 411
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-200-3314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care