Provider Demographics
NPI:1972007284
Name:ABRIA HOME CARE CORPORATION
Entity Type:Organization
Organization Name:ABRIA HOME CARE CORPORATION
Other - Org Name:FIRSTLIGHT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-510-5775
Mailing Address - Street 1:15 FRANKLIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3695
Mailing Address - Country:US
Mailing Address - Phone:219-510-5775
Mailing Address - Fax:219-286-7621
Practice Address - Street 1:15 FRANKLIN ST STE 200
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3695
Practice Address - Country:US
Practice Address - Phone:219-510-5775
Practice Address - Fax:219-286-7621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17-012914-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care