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General NPI Number Information
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NPI Number | 1386398360
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIVING HOME CARE LLC
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 6224 N PARK AVE # 1
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3330
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Country | US
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Telephone | 215-688-7008
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Fax |
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Provider Business Mailing Address
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Address Line | 6224 N PARK AVE FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3330
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Country | US
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Telephone | 215-688-7008
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Fax |
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Authorized Official
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Title or Position | OWNER / AGENCY DIRECTOR
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Name | SAKINAH KIDD
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Credential |
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Telephone | 215-688-7008
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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 |
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