Provider Demographics
NPI:1912387457
Name:ABBY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ABBY HEALTHCARE SERVICES
Other - Org Name:ABBY HEALTHCARE SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING (DON)
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUFUNMILAYO
Authorized Official - Middle Name:T
Authorized Official - Last Name:AJALA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:470-435-5341
Mailing Address - Street 1:550 WRENHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6232
Mailing Address - Country:US
Mailing Address - Phone:470-535-1524
Mailing Address - Fax:678-580-5491
Practice Address - Street 1:2151 FOUNTAIN DR STE 201
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6753
Practice Address - Country:US
Practice Address - Phone:678-615-7258
Practice Address - Fax:678-615-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-30
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222212251E00000X, 251J00000X, 251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care