Healthcare Provider Details

I. General information

NPI: 1114014685
Provider Name (Legal Business Name): ABA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 KENNEDY ST NW
WASHINGTON DC
20011
US

IV. Provider business mailing address

821 KENNEDY ST NW
WASHINGTON DC
20011-2913
US

V. Phone/Fax

Practice location:
  • Phone: 202-722-1725
  • Fax: 202-722-1726
Mailing address:
  • Phone: 202-722-1725
  • Fax: 202-722-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number0388650200
License Number StateDC

VIII. Authorized Official

Name: MR. JOHN NWOKONGOH FORETIA
Title or Position: CEO
Credential: ACCOUNTANT
Phone: 202-722-1725