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General NPI Number Information
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NPI Number | 1306270681
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE HOME HEALTH SERVICES
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 458 E WALNUT LN
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City | PHILADELPHIA
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State | PA
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Zip | 19144-1054
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Country | US
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Telephone | 267-257-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 458 E WALNUT LN
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City | PHILADELPHIA
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State | PA
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Zip | 19144-1054
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Country | US
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Telephone | 267-257-4431
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. GREGORY BELLEVUE
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Credential | B.S
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Telephone | 267-257-4431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | PA
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