Abundant Living Care LLC
Organization Active NPI Home Health Agency · Mequon, WI
NPI 1023549458 · NPPES record last updated Mar 27, 2017
Key facts
- NPI
- 1023549458
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- ABUNDANT LIVING CARE LLC
- Practice address
- 11431 N Port Washington Rd
Ste 290
Mequon, WI 53092-3462 - Phone
- (262) 834-6212
- NPI assigned
- Mar 27, 2017
- Organization subpart
- No
Authorized official
- Name
- Ms. Kiondra N Bohanon
- Title
- Administrator
- Phone
- (262) 834-6212
National Provider Directory
Locations
11431 N Port Washington Rd
Ste 290
Mequon, WI 53092
Phone (262) 834-6212
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
11431 N Port Washington Rd
Ste 290
Mequon, WI 53092-3462
Mailing address
11431 N Port Washington Rd
Ste 290
Mequon, WI 53092
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100062989 | Medicaid | WI |
Other providers in Mequon, WI
- Rebecca B. Abbott
- Allison Lee Abrahamson
- Bradley Lorin Abramson
- Zeki Abulughod
- James Aceto
- Achievement Associates Center Inc
- Achievement Associates, LTD
- Anna K Ackerman
- Active Care Home Health, Inc.
All providers in Mequon, WI · Home Health Agency in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.