Abundant Life Home Health Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

344067 Issued in MN

Legal business name

ABUNDANT LIFE HOME HEALTH CARE

Practice address

5901 Brooklyn Blvd.
Ste 110
Brooklyn Center, MN 55429-4017

Phone

(763) 843-0735

Fax

(763) 777-8727

NPI assigned

Jun 3, 2009

Last updated

May 28, 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

Mr. George Thomas Marshall

Title

Ceo

Phone

(763) 843-0735

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1639305774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6812 EWING AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291882",
            "telephone_number": "763-732-8391",
            "fax_number": "763-208-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BROOKLYN BLVD.",
            "address_2": "STE 110",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554294017",
            "telephone_number": "763-843-0735",
            "fax_number": "763-777-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-843-0735",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "343526",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "344067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.