Abundant Life Collaborative Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ABUNDANT LIFE COLLABORATIVE CARE LLC

Practice address

2621 Boulevard PL
Indianapolis, IN 46208-5623

Phone

(463) 273-5658

Fax

(317) 429-4423

NPI assigned

Oct 15, 2024

Last updated

Oct 15, 2024By 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

Tiara Robinson

Title

Owner

Phone

(463) 273-5658

Specialties & licenses 1

Addresses

Other names 1

• Abundant Life Collaborative Care LLC Former legal business name

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1609696418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 BOULEVARD PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085623",
            "telephone_number": "463-273-5658",
            "fax_number": "317-429-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 BOULEVARD PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085623",
            "telephone_number": "463-273-5658",
            "fax_number": "317-429-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE COLLABORATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "TIARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "463-273-5658"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abundant Life Collaborative Care LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• In Home Supportive Care Agency in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• In Home Supportive Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.