MEDICARE: ABUNDANT JOY RESIDENTIAL CARE 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	251X00000X	Supports Brokerage Agency

General Provider Information

NPI Number	:	1265389241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANT JOY RESIDENTIAL CARE LLC

Provider Business Mailing Address
First Line	:	1409 NE WEDDLE LN
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-3522
Country	:	US
Telephone Number	:	816-590-2616
Fax Number	:	816-590-2616

Provider Business Practice Location Address
First Line	:	1409 NE WEDDLE LN
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-3522
Country	:	US
Telephone Number	:	816-590-2616
Fax Number	:	816-590-2616

Authorized Official
Title or Position	:	OWNER
Name	:	COSMOSIC POLLARD
Credential	:	POLLARD
Telephone Number	:	816-590-2616

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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