Organization Active NPI

Abundant Enteprise LLC

  • Recovery Care Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1922640010
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recovery Care Clinic/CenterTaxonomy code 261QR0800X
Legal business name
ABUNDANT ENTEPRISE LLC
Practice address
5545 Lawnsberry Dr
Fort Worth, TX 76137-4390
Phone
(214) 493-1212
NPI assigned
Oct 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Dr. Adeola O Jaiyeola, MD
Title
Managing Director
Phone
(214) 493-1212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Recovery Care Clinic/Center 261QR0800X Primary

Addresses

Primary practice location

5545 Lawnsberry Dr
Fort Worth, TX 76137-4390

Mailing address

5545 Lawnsberry Dr
Fort Worth, TX 76137-4390
Phone (214) 493-1212

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1922640010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 LAWNSBERRY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374390",
            "telephone_number": "214-493-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 LAWNSBERRY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374390",
            "telephone_number": "214-493-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT ENTEPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "JAIYEOLA",
        "authorized_official_first_name": "ADEOLA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "214-493-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.