Organization · NPI-2
Abundant Life Senior Care LLC
Registered Nurse, Hospice · Florissant, MO
NPI number1063061778
StatusActive
Last updated in NPPESSep 5, 2019
Details
- NPI
- 1063061778
- Entity type
- Organization (NPI-2)
- Legal business name
- Abundant Life Senior Care LLC
- Organization subpart
- Yes
- Enumeration date
- Sep 5, 2019
- Last updated
- Sep 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WH1000X | Registered Nurse, Hospice | – | – | Yes |
Practice location
15606 Brunswick ManorFlorissant, MO 63034
Phone 314-709-8663
Mailing address
Po Box 866Florissant, MO 63032
Phone 314-709-8663
Authorized official
Jamica Nelson
Owner
3147098663
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