MEDICARE: ABBA PERSONAL HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1215578166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBA PERSONAL HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 478
Second Line	:
City	:	CHURCH POINT
State	:	LA
Zip	:	70525-0478
Country	:	US
Telephone Number	:	337-684-0411
Fax Number	:

Provider Business Practice Location Address
First Line	:	27136 HIGHWAY 23 STE 418
Second Line	:
City	:	PORT SULPHUR
State	:	LA
Zip	:	70083-2648
Country	:	US
Telephone Number	:	504-394-8806
Fax Number	:	337-684-1010

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EVELYN B FILIPINAS
Credential	:
Telephone Number	:	337-308-5474

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	10/02/2019

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