Abundant Possibilities and Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ABUNDANT POSSIBILITIES AND SERVICES, LLC

Practice address

208 Pine Dale Dr
Swansea, IL 62226-2336

Phone

(618) 225-2896

NPI assigned

Dec 6, 2021

Last updated

Dec 6, 2021By 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

Mr. Leontrez Jerome Dickerson, MPA

Title

President

Phone

(618) 225-2896

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1295493336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PINE DALE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262336",
            "telephone_number": "618-225-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PINE DALE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262336",
            "telephone_number": "618-225-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT POSSIBILITIES AND SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "LEONTREZ",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-225-2896",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ldickerson@abundantpossibilities.org",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "208 Pine Dale Dr",
            "city": "Swansea",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622262336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Swansea, IL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.