Provider Demographics
NPI:1497450498
Name:ABA HOME CARE LLC
Entity Type:Organization
Organization Name:ABA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURLYANDCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-544-6200
Mailing Address - Street 1:PO BOX 721513
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-0513
Mailing Address - Country:US
Mailing Address - Phone:248-544-6200
Mailing Address - Fax:586-408-6028
Practice Address - Street 1:17220 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2114
Practice Address - Country:US
Practice Address - Phone:248-544-6200
Practice Address - Fax:586-408-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health