Healthcare Provider Details

I. General information

NPI: 1255739389
Provider Name (Legal Business Name): ABRAHAM HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 WINDSOR ST APT 1
WORCESTER MA
01605-3731
US

IV. Provider business mailing address

29 WINDSOR ST APT 1
WORCESTER MA
01605-3731
US

V. Phone/Fax

Practice location:
  • Phone: 774-239-1362
  • Fax:
Mailing address:
  • Phone: 774-239-1362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ABRAHAM DANYARO
Title or Position: CEO
Credential:
Phone: 774-239-1362