Healthcare Provider Details

I. General information

NPI: 1386051209
Provider Name (Legal Business Name): ABBA HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E SOUTH BLVD SUITE 145
MONTGOMERY AL
36116-2515
US

IV. Provider business mailing address

P. O. BOX 231176
MONTGOMERY AL
36123
US

V. Phone/Fax

Practice location:
  • Phone: 334-284-4867
  • Fax: 334-284-4878
Mailing address:
  • Phone: 334-284-4867
  • Fax: 334-284-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number11702
License Number StateAL

VIII. Authorized Official

Name: MRS. ANNIE RIASE
Title or Position: DIRECTOR
Credential: SW
Phone: 334-284-4867