Abundant Hearts, LLC

Primary specialty

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

Legal business name

ABUNDANT HEARTS, LLC

Practice address

5010 Grove West Blvd Unit 2004
Stafford, TX 77477-2624

Phone

(832) 216-3356

NPI assigned

Jul 11, 2021

Last updated

Jul 11, 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

Derrick Deron Bradley

Title

Owner

Phone

(832) 216-3356

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625961600000",
    "number": "1639741630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 GROVE WEST BLVD UNIT 2004",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772624",
            "telephone_number": "832-216-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 GROVE WEST BLVD UNIT 2004",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772624",
            "telephone_number": "832-216-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT HEARTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-11",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "DERON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-216-3356"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Stafford, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.