Provider Demographics
NPI:1811400294
Name:ABC HEALTHCARE OF AMERICA, LLC.
Entity Type:Organization
Organization Name:ABC HEALTHCARE OF AMERICA, LLC.
Other - Org Name:ABC HEALTHCARE AND STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILOMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-612-2395
Mailing Address - Street 1:PO BOX 43686
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30336-0686
Mailing Address - Country:US
Mailing Address - Phone:678-612-2395
Mailing Address - Fax:
Practice Address - Street 1:5532 OLD NATIONAL HWY BLDG G
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-3277
Practice Address - Country:US
Practice Address - Phone:678-612-2395
Practice Address - Fax:404-973-0694
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABC HEALTHCARE OF AMERICA, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities