Healthcare Provider Details

I. General information

NPI: 1275659062
Provider Name (Legal Business Name): ABUNDANT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 NW REDWING DR
LEES SUMMIT MO
64063-2145
US

IV. Provider business mailing address

202 NW REDWING DR
LEES SUMMIT MO
64063-2145
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-5099
  • Fax: 816-347-8680
Mailing address:
  • Phone: 816-246-5099
  • Fax: 816-246-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateMO

VIII. Authorized Official

Name: MARTHA ANN PAGE
Title or Position: DIRECTOR
Credential: C.E.O.
Phone: 816-246-5099