Healthcare Provider Details

I. General information

NPI: 1275479669
Provider Name (Legal Business Name): ABC SOLUTION-HOME MODIFICATION SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MOUNTAINVIEW RD
MOUNT LAUREL NJ
08054-4730
US

IV. Provider business mailing address

6 LOCUST LN
NEWTOWN PA
18940-3249
US

V. Phone/Fax

Practice location:
  • Phone: 215-696-4697
  • Fax: 267-930-6261
Mailing address:
  • Phone: 215-696-4697
  • Fax: 267-930-6261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SERGUEI PETOUHOV
Title or Position: OWNER/MANAGER
Credential:
Phone: 215-696-4697