Provider Demographics
NPI:1669726162
Name:ABBA HEALTH CARE INSTITUTE
Entity type:Organization
Organization Name:ABBA HEALTH CARE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HASSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-805-3997
Mailing Address - Street 1:12008 CASTLE PINES LN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3183
Mailing Address - Country:US
Mailing Address - Phone:202-805-3997
Mailing Address - Fax:240-607-6760
Practice Address - Street 1:12008 CASTLE PINES LN
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3183
Practice Address - Country:US
Practice Address - Phone:202-805-3997
Practice Address - Fax:240-607-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX783687311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility