Organization
AVICENNA HOME CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDOULLAH KABBAJ (OWNER)
(909) 319-7475
Entity
Organization
Contact information
Practice address
8273 WHITE OAK AVE STE P, RANCHO CUCAMONGA, CA 91730-7671
(909) 329-2699
Mailing address
8273 WHITE OAK AVE STE P, RANCHO CUCAMONGA, CA 91730-7671
(909) 329-2699
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
364700107
CDSS - HOME CARE SERVICES BUREAU
CA
Enumeration date
11/21/2021
Last updated
11/21/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us