Provider Demographics
NPI:1386051209
Name:ABBA HOME CARE SERVICES
Entity type:Organization
Organization Name:ABBA HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIASE
Authorized Official - Suffix:
Authorized Official - Credentials:SW
Authorized Official - Phone:334-284-4867
Mailing Address - Street 1:P. O. BOX 231176
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123
Mailing Address - Country:US
Mailing Address - Phone:334-284-4867
Mailing Address - Fax:334-284-4878
Practice Address - Street 1:2600 E SOUTH BLVD
Practice Address - Street 2:SUITE 145
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2515
Practice Address - Country:US
Practice Address - Phone:334-284-4867
Practice Address - Fax:334-284-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251J00000X, 343900000X, 347C00000X
AL11702253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle