Organization
ABBA RESIDENTIAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MGBAM (PROGRAM ADMINISTRATOR)
(404) 484-0061
Entity
Organization
Contact information
Practice address
1144 WISHING WELL CT, CEDAR HILL, TX 75104-8254
(404) 484-0061
Mailing address
1144 WISHING WELL CT, CEDAR HILL, TX 75104-8254
(404) 484-0061
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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