Provider Demographics
NPI:1770714305
Name:ABRAHAM VILLAGE,INC.
Entity type:Organization
Organization Name:ABRAHAM VILLAGE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEZIAH
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:KOHATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-965-1774
Mailing Address - Street 1:239 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1012
Mailing Address - Country:US
Mailing Address - Phone:610-965-1774
Mailing Address - Fax:610-965-9469
Practice Address - Street 1:239 WILLOW ST
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-1012
Practice Address - Country:US
Practice Address - Phone:610-965-1774
Practice Address - Fax:610-965-9469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care