Provider Demographics
NPI:1881120772
Name:ABI'S IN HOME SENIOR CARE, LLC
Entity type:Organization
Organization Name:ABI'S IN HOME SENIOR CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-233-6467
Mailing Address - Street 1:15700 PROVIDENCE DR
Mailing Address - Street 2:400 C
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3144
Mailing Address - Country:US
Mailing Address - Phone:248-233-6467
Mailing Address - Fax:248-415-6289
Practice Address - Street 1:15700 PROVIDENCE DR
Practice Address - Street 2:400
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3144
Practice Address - Country:US
Practice Address - Phone:248-233-6467
Practice Address - Fax:248-415-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251C00000X, 251T00000X, 253Z00000X, 261QH0100X, 261QR0800X, 343900000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)