Healthcare Provider Details

I. General information

NPI: 1386413607
Provider Name (Legal Business Name): ABODE CARE PARTNERS AL VB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 BAYOU BLVD STE 54A
PENSACOLA FL
32503-1909
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7102
US

V. Phone/Fax

Practice location:
  • Phone: 800-807-6555
  • Fax: 855-316-2999
Mailing address:
  • Phone: 502-394-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALLISON BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-394-2100