Abundant Life Therapeutic Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

2154 Issued in VA

Legal business name

ABUNDANT LIFE THERAPEUTIC SERVICES LLC

Practice address

645 Church St.
Suite 104C
Norfolk, VA 23510

Phone

(757) 616-0657

Fax

(757) 533-9369

NPI assigned

Jul 22, 2013

Last updated

Jun 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melvin L Anderson

Title

Executive Director

Phone

(757) 616-0657

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1285076067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 CHURCH ST",
            "address_2": "SUITE 104C",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101712",
            "telephone_number": "757-616-0657",
            "fax_number": "757-533-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 CHURCH ST.",
            "address_2": "SUITE 104C",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23510",
            "telephone_number": "757-616-0657",
            "fax_number": "757-533-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-616-0657"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Chisman Abraham, LCSW
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• Alfred Z Abuhamad, M.D.
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• Access Health Educators of America (Access 2 Health)
• Access Health LLC
• Access Medical Supply Corporation
• Accessibility Incorporated

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.