Provider Demographics
NPI:1265149280
Name:ABACA HEALTH, LLC
Entity type:Organization
Organization Name:ABACA HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELVONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-528-0610
Mailing Address - Street 1:1317 BENNETT PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8416
Mailing Address - Country:US
Mailing Address - Phone:410-977-4726
Mailing Address - Fax:
Practice Address - Street 1:35 FULFORD AVE STE 202
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3941
Practice Address - Country:US
Practice Address - Phone:443-528-0610
Practice Address - Fax:410-776-3551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health