Healthcare Provider Details

I. General information

NPI: 1275715112
Provider Name (Legal Business Name): ABRAHAM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5718 HARFORD RD SUITE 204
BALTIMORE MD
21214-2237
US

IV. Provider business mailing address

5718 HARFORD RD SUITE 204
BALTIMORE MD
21214-2237
US

V. Phone/Fax

Practice location:
  • Phone: 410-254-3004
  • Fax: 410-254-3005
Mailing address:
  • Phone: 410-254-3004
  • Fax: 410-254-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR2326
License Number StateMD

VIII. Authorized Official

Name: MR. ABIODUN ONABIYI
Title or Position: PRESIDENT
Credential:
Phone: 410-254-3004