MEDICARE: ABUNDANCE HEALTH AND WELLNESS LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1245029297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANCE HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	4740 42ND AVE N STE 202
Second Line	:
City	:	ROBBINSDALE
State	:	MN
Zip	:	55422-1828
Country	:	US
Telephone Number	:	612-222-1979
Fax Number	:

Provider Business Practice Location Address
First Line	:	4740 42ND AVE N STE 202
Second Line	:
City	:	ROBBINSDALE
State	:	MN
Zip	:	55422-1828
Country	:	US
Telephone Number	:	612-222-1979
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EBISA WORIKA
Credential	:
Telephone Number	:	612-222-1979

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	12/08/2025

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