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General NPI Number Information
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NPI Number | 1770714305
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Entity Type | Organization
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Legal Business Name | ABRAHAM VILLAGE,INC.
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 239 WILLOW ST
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City | MACUNGIE
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State | PA
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Zip | 18062-1012
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Country | US
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Telephone | 610-965-1774
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Fax | 610-965-9469
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Provider Business Mailing Address
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Address Line | 239 WILLOW ST
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City | MACUNGIE
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State | PA
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Zip | 18062-1012
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Country | US
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Telephone | 610-965-1774
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Fax | 610-965-9469
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KEZIAH ESTHER KOHATH
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Credential |
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Telephone | 610-965-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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