Healthcare Provider Details

I. General information

NPI: 1356274302
Provider Name (Legal Business Name): ABUNDANT CARE RESIDENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 COLD SPRINGS CT
WELLINGTON FL
33414-5709
US

IV. Provider business mailing address

1444 COLD SPRINGS CT
WELLINGTON FL
33414-5709
US

V. Phone/Fax

Practice location:
  • Phone: 561-301-0498
  • Fax:
Mailing address:
  • Phone: 561-301-0498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MAXENE WALKER
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 561-301-0498