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General NPI Number Information
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NPI Number | 1922306406
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE NURSING SERVICES, INC.
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 6214 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-3425
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Country | US
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Telephone | 410-318-8106
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Fax | 410-318-8107
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Provider Business Mailing Address
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Address Line | 6214 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-3425
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Country | US
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Telephone | 410-318-8106
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Fax | 410-318-8107
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MR. INNOCENT AKPUAKA
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Credential | L.P.N
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Telephone | 410-984-7411
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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 | R2966
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License Number State | MD
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