Provider Demographics
NPI:1912510751
Name:ABC HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:ABC HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:GREETTEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:PORTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-748-3462
Mailing Address - Street 1:9766 SW 24TH ST STE 17AND
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7539
Mailing Address - Country:US
Mailing Address - Phone:786-706-1281
Mailing Address - Fax:
Practice Address - Street 1:9766 SW 24TH ST STE 17AND
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7539
Practice Address - Country:US
Practice Address - Phone:786-706-1281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-30
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center