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Organization
ABBEY'S HOME, LLC.
Active
Organization
ABBEY'S HOME, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAZARETH TESFASILASE RN,BSN (CEO)
(909) 782-6925
Entity
Organization
Contact information
Practice address
15554 ROCKWELL AVE, FONTANA, CA 92336
(909) 782-6925
Mailing address
15554 ROCKWELL AVE, FONTANA, CA 92336
(909) 782-6925
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201507210428
SECRETARY OF STATE
CA
Enumeration date
10/03/2021
Last updated
10/03/2021
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