Organization
ABBA HOME HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN KOOMSON (ADMINISTRATOR)
(469) 685-5756
Entity
Organization
Contact information
Practice address
12516 AUDELIA RD APT 1703, DALLAS, TX 75243-2263
(469) 685-5756
Mailing address
12516 AUDELIA RD APT 1703, DALLAS, TX 75243-2263
(469) 685-5756
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
05/03/2019
Last updated
06/11/2019
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