Healthcare Provider Details
I. General information
NPI: 1700647708
Provider Name (Legal Business Name): ABUNDANT HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2024
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
714 BROOKE AVE
MORTON PA
19070
US
IV. Provider business mailing address
714 BROOKE AVE
MORTON PA
19070
US
V. Phone/Fax
- Phone: 484-735-9358
- Fax:
- Phone: 484-735-9358
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MR.
GIBRILLA
TURAY
Title or Position: CEO
Credential:
Phone: 484-735-9358