Healthcare Provider Details

I. General information

NPI: 1407706690
Provider Name (Legal Business Name): ABUNDANCE OF LIFE CASE MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9121 INTERLINE AVE STE 9B
BATON ROUGE LA
70809-1973
US

IV. Provider business mailing address

9121 INTERLINE AVE STE 9B
BATON ROUGE LA
70809-1973
US

V. Phone/Fax

Practice location:
  • Phone: 225-330-2059
  • Fax: 225-612-6725
Mailing address:
  • Phone: 225-330-2059
  • Fax: 225-612-6725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KEOSHIA MONIQUE JACKSON-GREEN
Title or Position: OWNER
Credential:
Phone: 225-377-9121