Provider Demographics
NPI:1275796914
Name:ABBA TECHNICAL CENTER LLC
Entity Type:Organization
Organization Name:ABBA TECHNICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:VIDAD
Authorized Official - Last Name:RYSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-965-3756
Mailing Address - Street 1:4490 HOLLAND OFFICE PARK STE 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1177
Mailing Address - Country:US
Mailing Address - Phone:757-965-3756
Mailing Address - Fax:
Practice Address - Street 1:4490 HOLLAND OFFICE PARK SUITE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:757-965-3756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health