Healthcare Provider Details

I. General information

NPI: 1386571776
Provider Name (Legal Business Name): ABASI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 MILL CREEK DR
YOUNGSTOWN OH
44512-1549
US

IV. Provider business mailing address

66 MILL CREEK DR
YOUNGSTOWN OH
44512-1549
US

V. Phone/Fax

Practice location:
  • Phone: 330-409-9864
  • Fax: 561-437-8116
Mailing address:
  • Phone: 330-409-9864
  • Fax: 561-437-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: JUSTYN HARVEY
Title or Position: OWNER/CEO
Credential:
Phone: 904-415-4661