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General NPI Number Information
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NPI Number | 1003687526
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Entity Type | Organization
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Legal Business Name | ABUNDANT LOVE & CARE ASSISTED LIVING FACILITY 2 INC.
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 825 PLUM ST
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City | LAKELAND
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State | FL
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Zip | 33801-1970
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Country | US
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Telephone | 863-307-2421
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Fax | 863-307-2521
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Provider Business Mailing Address
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Address Line | 825 PLUM ST
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City | LAKELAND
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State | FL
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Zip | 33801-1970
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Country | US
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Telephone | 863-307-2421
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Fax | 863-307-2521
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Authorized Official
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Title or Position | OWNER/ADMINISTATOR
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Name | MRS. GLADIS VACCIANNA
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Credential | RN
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Telephone | 863-860-5699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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