Provider Demographics
NPI:1972500213
Name:ABBA CARE CORPORATION
Entity Type:Organization
Organization Name:ABBA CARE CORPORATION
Other - Org Name:REGENCY HEIGHTS-DETROIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ASHRAF
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-386-0300
Mailing Address - Street 1:19100 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-2758
Mailing Address - Country:US
Mailing Address - Phone:313-533-5002
Mailing Address - Fax:313-533-5009
Practice Address - Street 1:19100 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-2758
Practice Address - Country:US
Practice Address - Phone:313-533-5002
Practice Address - Fax:313-533-5009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIENA HEALTHCARE MANAGEMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-01
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI09502OtherBCBSM
MI2154267Medicaid
MI2154267Medicaid