Provider Demographics
NPI:1760993885
Name:ABBA CARE FOR ELDERS L.L.C
Entity Type:Organization
Organization Name:ABBA CARE FOR ELDERS L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:STYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-557-3899
Mailing Address - Street 1:468 ABELLO RD SE BAY FL
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-8838
Mailing Address - Country:US
Mailing Address - Phone:321-557-3747
Mailing Address - Fax:
Practice Address - Street 1:468 ABELLO RD SE BAY FL
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-8838
Practice Address - Country:US
Practice Address - Phone:321-557-3747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty