MEDICARE: ABUNDANT LIVING AT PETERSONS 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	164W00000X	Licensed Practical Nurse
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	CER-00114910	PA

General Provider Information

NPI Number	:	1407369408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANT LIVING AT PETERSONS INC

Provider Business Mailing Address
First Line	:	3884 EAST ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15214-2029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3884 EAST ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15214-2029
Country	:	US
Telephone Number	:	412-231-7866
Fax Number	:

Authorized Official
Title or Position	:	CEO CFO
Name	:	KENNETH PETERSON
Credential	:
Telephone Number	:	412-231-7866

Provider Enumeration Date	:	11/13/2017
Last Update Date	:	11/22/2017

Similar Medicare Providers

1871006999 — YVONNE PETERSON
Practice Location Address:

3884 EAST ST
PITTSBURGH, PA
15214-2029

Practice Phone: 412-231-7866
Practice Fax:

1164472429 — DR. BARTON B. RACK O.D.
Practice Location Address:

9 LINSHAW AVE
PITTSBURGH, PA
15205-2029

Practice Phone: 412-921-5470
Practice Fax: 412-921-5580

1720234198 — MS. SHEILA Y RAZA-SELF M. ED.
Practice Location Address:

565 GREENHURST DR
PITTSBURGH, PA
15243-2029

Practice Phone: 412-605-9441
Practice Fax:

1457695926 — ELCY SANDORA OTR/L
Practice Location Address:

966 WASHINGTON RD
PITTSBURGH, PA
15228-2029

Practice Phone: 412-561-1885
Practice Fax:

1023016037 — REFORMED PRESBYTERIAN WOMAN'S ASSOCIATION
Practice Location Address:

2344 PERRYSVILLE AVE
PITTSBURGH, PA
15214-3560

Practice Phone: 412-321-4139
Practice Fax: 412-321-4661

1255445813 — PRESSLEY RIDGE SCHOOL
Practice Location Address:

530 MARSHALL AVE
PITTSBURGH, PA
15214-3016

Practice Phone: 412-442-4474
Practice Fax:

Directions to “ABUNDANT LIVING AT PETERSONS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.