Provider Demographics
NPI:1497019285
Name:ABAZINNIA ACQUIRED BRAIN INJURY SERVICES INC
Entity Type:Organization
Organization Name:ABAZINNIA ACQUIRED BRAIN INJURY SERVICES INC
Other - Org Name:ABAZINNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-487-1523
Mailing Address - Street 1:15 HUNTERS TRL
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2701
Mailing Address - Country:US
Mailing Address - Phone:774-487-1523
Mailing Address - Fax:207-956-5799
Practice Address - Street 1:1167 CAPE RD
Practice Address - Street 2:
Practice Address - City:HOLLIS CENTER
Practice Address - State:ME
Practice Address - Zip Code:04042-3037
Practice Address - Country:US
Practice Address - Phone:207-370-2430
Practice Address - Fax:207-956-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care