Provider Demographics
NPI:1679336713
Name:ABUNDANT HOME CARE, LLC
Entity type:Organization
Organization Name:ABUNDANT HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS-MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-487-0612
Mailing Address - Street 1:935 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3414
Mailing Address - Country:US
Mailing Address - Phone:954-487-0612
Mailing Address - Fax:
Practice Address - Street 1:6043 KIMBERLY BLVD STE R
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2826
Practice Address - Country:US
Practice Address - Phone:954-216-4418
Practice Address - Fax:888-422-4193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care