Healthcare Provider Details

I. General information

NPI: 1356263370
Provider Name (Legal Business Name): ABUNDANT LIVING PERSONAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 MOCCASIN CT
INDIANAPOLIS IN
46235-3414
US

IV. Provider business mailing address

3232 MOCCASIN CT
INDIANAPOLIS IN
46235-3414
US

V. Phone/Fax

Practice location:
  • Phone: 317-473-4781
  • Fax:
Mailing address:
  • Phone: 317-473-4781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: LATOEIE DANIELS
Title or Position: OWNER
Credential:
Phone: 317-459-0940