Provider Demographics
NPI:1144967761
Name:ABC HOME HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:ABC HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DIRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-326-9377
Mailing Address - Street 1:3055 OLD HIGHWAY 8 STE 111
Mailing Address - Street 2:
Mailing Address - City:ST ANTHONY
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2577
Mailing Address - Country:US
Mailing Address - Phone:612-326-9377
Mailing Address - Fax:612-326-1206
Practice Address - Street 1:3055 OLD HIGHWAY 8 STE 111
Practice Address - Street 2:
Practice Address - City:ST ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55418-2577
Practice Address - Country:US
Practice Address - Phone:612-326-9377
Practice Address - Fax:612-326-1206
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABC HOME HEALTH CARE PLUS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care