MEDICARE: ABUNDANCE FOUNDATION INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1114695665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANCE FOUNDATION INC.

Provider Business Mailing Address
First Line	:	2221 STACY DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-4637
Country	:	US
Telephone Number	:	720-255-5458
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 STACY DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-4637
Country	:	US
Telephone Number	:	720-255-5458
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/EXECUTIVE DIRECTOR
Name	:	BRIAN JAMES BAUER
Credential	:	CAS, RPC
Telephone Number	:	720-255-5458

Provider Enumeration Date	:	08/31/2021
Last Update Date	:	08/31/2021

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