=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891429601
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABIGAEL HOUSE OF CARE LLC ABIGAEL HOME HEALTH AGENCY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2022
-----------------------------------------------------
Last Update Date | 07/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7451 RIVIERA BLVD STE 215
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-6572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-605-5077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7451 RIVIERA BLVD STE 215
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-6572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-605-5077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. PHILOMENE LAMBERT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-262-3619
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------