Provider Demographics
NPI:1790083087
Name:KABOF HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:KABOF HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:OLUFUNKE
Authorized Official - Last Name:FAGUN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:908-486-0891
Mailing Address - Street 1:225 N WOOD AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4200
Mailing Address - Country:US
Mailing Address - Phone:908-486-0891
Mailing Address - Fax:908-486-0963
Practice Address - Street 1:225 N WOOD AVE STE 9
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4200
Practice Address - Country:US
Practice Address - Phone:908-486-0891
Practice Address - Fax:908-486-0963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHPO152000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health