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General NPI Number Information
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NPI Number | 1902038417
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Entity Type | Organization
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Legal Business Name | MORE ABUNDANT LIVING INSTITUTE, P.C.
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 19516 NORTHWINDS DR
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City | LYNWOOD
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State | IL
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Zip | 60411-8660
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Country | US
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Telephone | 708-799-5862
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Fax | 708-799-0138
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Provider Business Mailing Address
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Address Line | 19516 NORTHWINDS DR
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City | LYNWOOD
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State | IL
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Zip | 60411-8660
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Country | US
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Telephone | 708-799-5862
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Fax | 708-799-0138
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ROSETTA WEBB
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Credential | LSW
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Telephone | 708-799-5862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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