Provider Demographics
NPI:1336624493
Name:ABAMA HOME CARE INC
Entity Type:Organization
Organization Name:ABAMA HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALALJAFAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-696-3722
Mailing Address - Street 1:1220 S PARKER RD STE 200E
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2114
Mailing Address - Country:US
Mailing Address - Phone:303-696-3722
Mailing Address - Fax:303-696-3721
Practice Address - Street 1:1220 S PARKER RD STE 200E
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2114
Practice Address - Country:US
Practice Address - Phone:303-696-3722
Practice Address - Fax:303-696-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO78437377Medicaid