MEDICARE: ABS SUPPORT SERVICES, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency		FL

General Provider Information

NPI Number	:	1578788600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABS SUPPORT SERVICES, INC.

Provider Business Mailing Address
First Line	:	215 N SAINT THOMAS CIR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-2256
Country	:	US
Telephone Number	:	813-786-1281
Fax Number	:	813-645-8140

Provider Business Practice Location Address
First Line	:	215 N SAINT THOMAS CIR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-2256
Country	:	US
Telephone Number	:	813-786-1281
Fax Number	:	813-645-8140

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ANITA M OLSON
Credential	:
Telephone Number	:	813-786-1281

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	11/23/2007

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