Abundant Life Senior Care LLC

Primary specialty

Hospice Registered NurseTaxonomy code 163WH1000X

Legal business name

ABUNDANT LIFE SENIOR CARE LLC

Practice address

15606 Brunswick Manor
Florissant, MO 63034

Phone

(314) 709-8663

NPI assigned

Sep 5, 2019

Last updated

Sep 5, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

ABUNDANT LIFE SENIOR CARE LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jamica Nelson

Title

Owner

Phone

(314) 709-8663

Specialties & licenses 1

Addresses

Part of

Abundant Life Senior Care LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1063061778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 866",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "63032",
            "telephone_number": "314-709-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15606 BRUNSWICK MANOR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "63034",
            "telephone_number": "314-709-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE SENIOR CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABUNDANT LIFE SENIOR CARE LLC",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JAMICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-709-8663"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospice Registered Nurse in Florissant, MO
• Providers in Florissant, MO by specialty
• Hospice Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.