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General NPI Number Information
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NPI Number | 1770724205
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Entity Type | Organization
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Legal Business Name | ABA HOMECARE PROVIDERS, INC
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 3900 NW 79TH AVE SUITE 446
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-594-2171
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Fax | 305-594-2172
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Provider Business Mailing Address
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Address Line | 3900 NW 79TH AVE SUITE 446
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-594-2171
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Fax | 305-594-2172
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Authorized Official
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Title or Position | DIRECTOR OF NURSING/OWNER
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Name | MR. WIRLEN ALEXANDER ANTIGUA
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Credential | RN
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Telephone | 305-710-3653
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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 | FL
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