# ABBEY'S HOME, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164194684
- **Authorized official:** NAZARETH TESFASILASE RN,BSN (CEO)
- **Authorized official phone:** (909) 782-6925

## Contact information

- **Practice address:** 15554 ROCKWELL AVE, FONTANA, CA 92336
- **Practice address phone:** (909) 782-6925
- **Mailing address:** 15554 ROCKWELL AVE, FONTANA, CA 92336
- **Mailing address phone:** (909) 782-6925

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 177F00000X | Lodging Provider | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2021
- **Last updated:** 10/03/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 201507210428 | SECRETARY OF STATE | CA |