Healthcare Provider Details

I. General information

NPI: 1871400655
Provider Name (Legal Business Name): ABUNDANT LIFESKILLS COMMUNITY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16180 MEYERS RD
DETROIT MI
48235-4107
US

IV. Provider business mailing address

16180 MEYERS RD
DETROIT MI
48235-4107
US

V. Phone/Fax

Practice location:
  • Phone: 734-658-2662
  • Fax:
Mailing address:
  • Phone: 734-658-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGOIRE EUGENE-LOUIS SR.
Title or Position: CEO
Credential:
Phone: 734-658-2662