Provider Demographics
NPI:1013786938
Name:MAABU HOMECARE LLC
Entity Type:Organization
Organization Name:MAABU HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALUDA
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:SISTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-360-2647
Mailing Address - Street 1:102 N KROHN PL STE 216
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-1847
Mailing Address - Country:US
Mailing Address - Phone:605-360-2647
Mailing Address - Fax:
Practice Address - Street 1:102 N KROHN PL STE 216
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-1847
Practice Address - Country:US
Practice Address - Phone:605-360-2647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health