Provider Demographics
NPI:1326779836
Name:ABYAN CARE LLC
Entity Type:Organization
Organization Name:ABYAN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARMARKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-978-4909
Mailing Address - Street 1:4111 CENTRAL AVE NE STE 208H
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2953
Mailing Address - Country:US
Mailing Address - Phone:612-223-5124
Mailing Address - Fax:
Practice Address - Street 1:4111 CENTRAL AVE NE STE 208H
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2953
Practice Address - Country:US
Practice Address - Phone:612-223-5435
Practice Address - Fax:763-777-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA221955100Other254D