Provider Demographics
NPI:1518739895
Name:ABC HOME CARE LLC
Entity Type:Organization
Organization Name:ABC HOME CARE LLC
Other - Org Name:ABC HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AFIAVI
Authorized Official - Middle Name:C
Authorized Official - Last Name:DADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-508-9112
Mailing Address - Street 1:21801 STRATFORD ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2533
Mailing Address - Country:US
Mailing Address - Phone:248-508-9112
Mailing Address - Fax:855-213-4125
Practice Address - Street 1:21801 STRATFORD ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2533
Practice Address - Country:US
Practice Address - Phone:248-508-9112
Practice Address - Fax:855-213-4125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care