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General NPI Number Information
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NPI Number | 1295039030
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Entity Type | Organization
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Legal Business Name | ABBA HEALTHCARE ENTERPRISES, L.L.C.
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 645 ST.LOUIS. AVE. SUITE 200
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City | FORT WORTH
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State | TX
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Zip | 76104
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Country | US
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Telephone | 817-332-4004
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Fax | 817-332-4224
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Provider Business Mailing Address
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Address Line | 2716 COUNTY ROAD 804A
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City | BURLESON
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State | TX
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Zip | 76028-1950
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Country | US
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Telephone | 817-447-8426
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Fax | 817-447-9958
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CLARA ELIZABETH MOSES
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Credential | R.N. CNOR
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Telephone | 817-332-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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