Provider Demographics
NPI:1922603000
Name:ABC CARE PROVIDER LLC- ANDOVER MA
Entity Type:Organization
Organization Name:ABC CARE PROVIDER LLC- ANDOVER MA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:W
Authorized Official - Last Name:NDIRANGU
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:978-944-8697
Mailing Address - Street 1:300 BRICKSTONE SQ STE 201
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1497
Mailing Address - Country:US
Mailing Address - Phone:978-944-8697
Mailing Address - Fax:
Practice Address - Street 1:300 BRICKSTONE SQ STE 201
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1497
Practice Address - Country:US
Practice Address - Phone:978-944-8697
Practice Address - Fax:978-268-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health