Provider Demographics
NPI:1437501244
Name:SEBA PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:SEBA PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERHIUVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-856-2078
Mailing Address - Street 1:10432 BALLS FORD RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2514
Mailing Address - Country:US
Mailing Address - Phone:703-856-2078
Mailing Address - Fax:
Practice Address - Street 1:10432 BALLS FORD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2514
Practice Address - Country:US
Practice Address - Phone:703-856-2078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health