ABBTA INC
Adult Care Home
Portage, Michigan
Provider NPI: 1073755336
Organization Information:Organization Name: ABBTA INC
Practice Location:
5508 MOUNT VERNON AVE PORTAGE, MI 49024 US
Tel: 269-342-5886 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
5508 MOUNT VERNON AVE PORTAGE, MI 49024 US
Tel: 269-342-5886 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | MI | AS390290297 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
2097746 | MI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin