Healthcare Provider Details

I. General information

NPI: 1265389241
Provider Name (Legal Business Name): ABUNDANT JOY RESIDENTIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 NE WEDDLE LN
LEES SUMMIT MO
64086-3522
US

IV. Provider business mailing address

1409 NE WEDDLE LN
LEES SUMMIT MO
64086-3522
US

V. Phone/Fax

Practice location:
  • Phone: 816-590-2616
  • Fax: 816-590-2616
Mailing address:
  • Phone: 816-590-2616
  • Fax: 816-590-2616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: COSMOSIC POLLARD
Title or Position: OWNER
Credential: POLLARD
Phone: 816-590-2616