Provider Demographics
NPI:1275715112
Name:ABRAHAM HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:ABRAHAM HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ONABIYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-254-3004
Mailing Address - Street 1:5718 HARFORD RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2237
Mailing Address - Country:US
Mailing Address - Phone:410-254-3004
Mailing Address - Fax:410-254-3005
Practice Address - Street 1:5718 HARFORD RD
Practice Address - Street 2:SUITE 204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2237
Practice Address - Country:US
Practice Address - Phone:410-254-3004
Practice Address - Fax:410-254-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X
MDR2326251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty