Provider Demographics
NPI:1245403484
Name:ABELLA YOSE CARE SERVICE, INC.
Entity type:Organization
Organization Name:ABELLA YOSE CARE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ONEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-362-1128
Mailing Address - Street 1:5901 NW 151ST ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2428
Mailing Address - Country:US
Mailing Address - Phone:305-362-1128
Mailing Address - Fax:305-362-1129
Practice Address - Street 1:5901 NW 151ST ST
Practice Address - Street 2:SUITE 217
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2451
Practice Address - Country:US
Practice Address - Phone:305-362-1128
Practice Address - Fax:305-362-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 253Z00000X, 261Q00000X
FL299993012251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114476900Medicaid
FL100810800Medicaid
FL021079700Medicaid