Healthcare Provider Details
I. General information
NPI: 1881545085
Provider Name (Legal Business Name): ABUNDANT LIVING HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2026
Last Update Date: 03/08/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
299 ROBERT F HARGROVE RD
MOUNT OLIVE NC
28365-8338
US
IV. Provider business mailing address
507 W MAIN ST APT B
MOUNT OLIVE NC
28365-1937
US
V. Phone/Fax
- Phone: 919-223-2709
- Fax:
- Phone: 919-223-2709
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3104A0630X |
| Taxonomy | Assisted Living Facility (Behavioral Disturbances) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310500000X |
| Taxonomy | Mental Illness Intermediate Care Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3104A0625X |
| Taxonomy | Assisted Living Facility (Mental Illness) |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 315P00000X |
| Taxonomy | Intellectual Disabilities Intermediate Care Facility |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAMEKA
PATRICE
GILLIAM
Title or Position: CEO
Credential: PHD
Phone: 919-223-2709