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General NPI Number Information
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NPI Number | 1194593921
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Entity Type | Organization
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Legal Business Name | ABUNDANCE OF JOY HOME CARE
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 409 N FREDONIA ST STE 104
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City | LONGVIEW
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State | TX
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Zip | 75601-6466
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Country | US
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Telephone | 888-553-7133
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Fax |
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Provider Business Mailing Address
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Address Line | 409 N FREDONIA ST STE 104
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City | LONGVIEW
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State | TX
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Zip | 75601-6466
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Country | US
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Telephone | 888-553-7133
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TARA GREEN MIMS
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Credential |
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Telephone | 903-736-3427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 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 #4
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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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