Healthcare Provider Details

I. General information

NPI: 1750148086
Provider Name (Legal Business Name): ABUNDANT HEARTS HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 CENTRAL AVE
LAUREL MS
39440-3955
US

IV. Provider business mailing address

542 CENTRAL AVE
LAUREL MS
39440-3955
US

V. Phone/Fax

Practice location:
  • Phone: 601-425-3412
  • Fax:
Mailing address:
  • Phone: 601-425-3412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMILAH JONES
Title or Position: CEO
Credential:
Phone: 601-671-1811