Organization Active NPI

Abundance of Life Inc

  • Non-emergency Medical Transport (VAN)
  • Glendale, WI
National Provider Identifier
1508375775
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
ABUNDANCE OF LIFE INC
Practice address
2602 W Silver Spring Dr
Suite 200
Glendale, WI 53209-4292
Phone
(414) 256-5000
Fax
(844) 274-3572
NPI assigned
Sep 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Authorized official

Name
Natalia M Young
Title
Ceo
Phone
(414) 737-0708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X WI Primary

Addresses

Primary practice location

2602 W Silver Spring Dr
Suite 200
Glendale, WI 53209-4292

Mailing address

PO Box 101009
Milwaukee, WI 53210-7009
Phone (414) 256-5000

Other identifiers 1

IdentifierTypeStateIssuer
100058167MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Abundance of Life Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2602 W Silver Spring Dr
Ste 200
Glendale, WI 53209
Phone (414) 256-5000

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1508375775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101009",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532107009",
            "telephone_number": "414-256-5000",
            "fax_number": "844-274-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 W SILVER SPRING DR",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094292",
            "telephone_number": "414-256-5000",
            "fax_number": "844-274-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANCE OF LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-737-0708"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100058167",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.