Healthcare Provider Details

I. General information

NPI: 1114657533
Provider Name (Legal Business Name): ABENA HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 11/29/2024
Certification Date: 11/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4521 SADDLE BEND TRL
SNELLVILLE GA
30039-5984
US

IV. Provider business mailing address

507 BARLOW PL
GRAYSON GA
30017-4995
US

V. Phone/Fax

Practice location:
  • Phone: 770-597-5677
  • Fax:
Mailing address:
  • Phone: 404-725-7135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PAMELA STANLEY
Title or Position: CO-OWNER
Credential:
Phone: 770-597-5677