Provider Demographics
NPI:1730653676
Name:AB HOME CARE LLC
Entity Type:Organization
Organization Name:AB HOME CARE LLC
Other - Org Name:ANGEL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PISTORIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-334-4450
Mailing Address - Street 1:629 E WOOD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-3752
Mailing Address - Country:US
Mailing Address - Phone:609-334-4450
Mailing Address - Fax:888-358-1521
Practice Address - Street 1:629 E WOOD ST STE 101
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-3752
Practice Address - Country:US
Practice Address - Phone:609-334-4450
Practice Address - Fax:888-358-1521
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A BETTER HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-14
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0573744Medicaid