Organization · NPI-2

Abundant Life Assisted Living LLC

Assisted Living Facility · Los Angeles, CA

NPI number1003762014
StatusActive
Last updated in NPPESMar 10, 2026

Details

NPI
1003762014
Entity type
Organization (NPI-2)
Legal business name
Abundant Life Assisted Living LLC
Organization subpart
No
Enumeration date
Mar 10, 2026
Certification date
Mar 10, 2026
Last updated
Mar 10, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility––Yes

Practice location

1201 W 75th St
Los Angeles, CA 90044-2405

Phone 310-926-7574

Mailing address

7252 Archibald Ave # 543
Rancho Cucamonga, CA 91701-5017

Phone 310-926-7574

Authorized official

Quianna Street
Licensee
3106969555

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