Healthcare Provider Details

I. General information

NPI: 1427975531
Provider Name (Legal Business Name): ABODE CARE PARTNERS VB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGHLAND COLONY PKWY
RIDGELAND MS
39157-2073
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7102
US

V. Phone/Fax

Practice location:
  • Phone: 502-394-2100
  • Fax: 502-394-2159
Mailing address:
  • Phone: 502-394-2100
  • Fax: 502-394-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ALLISON BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-394-2100