Provider Demographics
NPI:1962827600
Name:ABC HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:ABC HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON-RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-455-0925
Mailing Address - Street 1:633 E JOLLY RD STE 3A
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:633 E JOLLY RD
Practice Address - Street 2:3A
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6803
Practice Address - Country:US
Practice Address - Phone:517-455-0925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care