Provider Demographics
NPI:1710708920
Name:ATABA ORGANIZATION LLC
Entity type:Organization
Organization Name:ATABA ORGANIZATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XAVIER ATABA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANYANGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-245-7305
Mailing Address - Street 1:3674 ELMORE CT E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2843
Mailing Address - Country:US
Mailing Address - Phone:216-301-9406
Mailing Address - Fax:
Practice Address - Street 1:3674 ELMORE CT E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2843
Practice Address - Country:US
Practice Address - Phone:216-301-9406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No273Y00000XHospital UnitsRehabilitation Unit
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit