Provider Demographics
NPI:1891501060
Name:ABBA LEGACY HOME CARE
Entity type:Organization
Organization Name:ABBA LEGACY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-981-3546
Mailing Address - Street 1:348 KATIE ELDER DR
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-0790
Mailing Address - Country:US
Mailing Address - Phone:512-677-4344
Mailing Address - Fax:
Practice Address - Street 1:348 KATIE ELDER DR
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-0790
Practice Address - Country:US
Practice Address - Phone:512-677-4344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health