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General NPI Number Information
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NPI Number | 1356813885
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE NURSING LLC
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Dates
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Enumeration Date | 12/21/2018
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 2799 W OLD US HIGHWAY 441
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City | MOUNT DORA
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State | FL
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Zip | 32757-3536
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Country | US
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Telephone | 352-250-2748
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Fax |
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Provider Business Mailing Address
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Address Line | 2280 W OLD US HIGHWAY 441
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City | MOUNT DORA
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State | FL
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Zip | 32757-3508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | PATRICIA ALLEN
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Credential |
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Telephone | 352-250-2748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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