NPIMap

Organization Active NPI

Abundant Life Care Services, LLC

  • Community/Behavioral Health Agency
  • Winston Salem, NC
National Provider Identifier
1982840492
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ABUNDANT LIFE CARE SERVICES, LLC
Practice address
163 Stratford CT
Suite 236
Winston Salem, NC 27103-1836
Phone
(336) 682-2908
NPI assigned
Jan 5, 2009
Last updated
Jan 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Mr. Clarence Carter
Title
Ceo
Phone
(336) 682-2908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

163 Stratford CT
Suite 236
Winston Salem, NC 27103-1836

Mailing address

163 Stratford CT
Box 26
Winston Salem, NC 27103-1836
Phone (336) 682-2908

National Provider Directory

National Provider Directory

Locations

163 Stratford Ct
#26
Winston Salem, NC 27103

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1982840492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 STRATFORD CT",
            "address_2": "BOX 26",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031836",
            "telephone_number": "336-682-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 STRATFORD CT",
            "address_2": "SUITE 236",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031836",
            "telephone_number": "336-682-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-682-2908",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.