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General NPI Number Information
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NPI Number | 1497450498
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Entity Type | Organization
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Legal Business Name | ABA HOME CARE LLC
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 17220 W 12 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2114
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Country | US
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Telephone | 248-544-6200
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Fax | 586-408-6028
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Provider Business Mailing Address
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Address Line | PO BOX 721513
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City | BERKLEY
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State | MI
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Zip | 48072-0513
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Country | US
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Telephone | 248-544-6200
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Fax | 586-408-6028
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Authorized Official
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Title or Position | MANAGER
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Name | KRISTINA KURLYANDCHIK
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Credential |
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Telephone | 248-544-6200
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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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