Healthcare Provider Details

I. General information

NPI: 1669605994
Provider Name (Legal Business Name): ABUNDANCE OF LOVE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 09/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E COLUMBUS ST
WHITEVILLE NC
28472-4218
US

IV. Provider business mailing address

212 E COLUMBUS ST
WHITEVILLE NC
28472-4218
US

V. Phone/Fax

Practice location:
  • Phone: 910-914-0711
  • Fax: 910-914-0711
Mailing address:
  • Phone: 910-914-0711
  • Fax: 910-914-0711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. BETTY FRINK STURDIVANT
Title or Position: OWNER
Credential: RN
Phone: 910-914-0711