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General NPI Number Information
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NPI Number | 1124996814
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Entity Type | Organization
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Legal Business Name | ABUNDANCE OF GRACE HOMECARE
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Dates
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Enumeration Date | 10/25/2025
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Last Update Date | 10/25/2025
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Provider Practice Location Address
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Address Line | 400 RENAISSANCE CTR
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City | DETROIT
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State | MI
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Zip | 48243-1502
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Country | US
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Telephone | 318-252-8839
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Fax | 318-252-8840
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Provider Business Mailing Address
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Address Line | 717 CROCKETT ST
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City | SHREVEPORT
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State | LA
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Zip | 71101-3605
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Country | US
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Telephone | 318-252-8839
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Fax | 318-252-8840
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Authorized Official
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Title or Position | OWNER/CEO
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Name | GENEVA VICTORIA SMITH
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Credential |
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Telephone | 318-252-8839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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