Provider Demographics
NPI:1114208360
Name:ABBA HOME CARE, LLC
Entity type:Organization
Organization Name:ABBA HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DELMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-630-4514
Mailing Address - Street 1:40 SOUTHBRIDGE ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2037
Mailing Address - Country:US
Mailing Address - Phone:508-630-4514
Mailing Address - Fax:508-966-7098
Practice Address - Street 1:40 SOUTHBRIDGE ST STE 310
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2037
Practice Address - Country:US
Practice Address - Phone:508-630-4514
Practice Address - Fax:508-966-7098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1190093428DMedicaid