Provider Demographics
NPI:1699051946
Name:ABCW HOME HEALTH CARE AGENCY,LLC
Entity type:Organization
Organization Name:ABCW HOME HEALTH CARE AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDIWAHAB
Authorized Official - Middle Name:M
Authorized Official - Last Name:YUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-643-5985
Mailing Address - Street 1:1672 S 9TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-3426
Mailing Address - Country:US
Mailing Address - Phone:414-643-5985
Mailing Address - Fax:
Practice Address - Street 1:1672 S 9TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3426
Practice Address - Country:US
Practice Address - Phone:414-643-5985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1162251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health