Provider Demographics
NPI:1295039030
Name:ABBA HEALTHCARE ENTERPRISES, L.L.C.
Entity Type:Organization
Organization Name:ABBA HEALTHCARE ENTERPRISES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:RN CNOR
Authorized Official - Phone:817-332-4004
Mailing Address - Street 1:2716 COUNTY ROAD 804A
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-1950
Mailing Address - Country:US
Mailing Address - Phone:817-447-8426
Mailing Address - Fax:817-447-9958
Practice Address - Street 1:645 ST.LOUIS. AVE. SUITE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104
Practice Address - Country:US
Practice Address - Phone:817-332-4004
Practice Address - Fax:817-332-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health