Abundant Life Residential Services

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

ABUNDANT LIFE RESIDENTIAL SERVICES

Practice address

8000 Prince Georges Dr
Fort Washington, MD 20744-2264

Phone

(202) 498-4557

NPI assigned

Jun 15, 2011

Last updated

Jun 15, 2011By 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

Latonya Patrice Powell

Title

Director

Phone

(202) 498-4557

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1912292129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 PRINCE GEORGES DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207442264",
            "telephone_number": "202-498-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 PRINCE GEORGES DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207442264",
            "telephone_number": "202-498-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "LATONYA",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "202-498-4557"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035966800",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• Contractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.