MEDICARE: AB ADVANCED SERVICES

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1386134377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AB ADVANCED SERVICES

Provider Business Mailing Address
First Line	:	4312 CEYLON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6502
Country	:	US
Telephone Number	:	303-246-8657
Fax Number	:	303-373-0990

Provider Business Practice Location Address
First Line	:	4312 CEYLON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6502
Country	:	US
Telephone Number	:	303-246-8657
Fax Number	:	303-373-0990

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	AIDA BADIANE
Credential	:
Telephone Number	:	303-246-8657

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	05/15/2018

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