Provider Demographics
NPI:1851263776
Name:ABANTUU AASSISTED LIVING LLC
Entity type:Organization
Organization Name:ABANTUU AASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GATHIRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-370-9649
Mailing Address - Street 1:1392 JOYCE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3277
Mailing Address - Country:US
Mailing Address - Phone:907-370-9649
Mailing Address - Fax:
Practice Address - Street 1:1392 JOYCE DR
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3277
Practice Address - Country:US
Practice Address - Phone:907-370-9649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services