Provider Demographics
NPI:1013468412
Name:AWBA, LLC
Entity Type:Organization
Organization Name:AWBA, LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGOVERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-251-3938
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-0344
Mailing Address - Country:US
Mailing Address - Phone:978-251-3938
Mailing Address - Fax:978-251-0758
Practice Address - Street 1:63 MIDDLESEX ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1583
Practice Address - Country:US
Practice Address - Phone:978-251-3938
Practice Address - Fax:978-251-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health