# ABUNDANT HEALTH MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Abundant Health Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003288614
- **Authorized official:** DR. ADRIENNE CHANELLE ROBERTSON M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (334) 294-2758

## Contact information

- **Practice address:** 1001 JACKSON ST, THIBODAUX, LA 70301-3227
- **Practice address phone:** (985) 492-9111
- **Practice address fax:** (985) 492-9114
- **Mailing address:** PO BOX 5011, THIBODAUX, LA 70302-5011
- **Mailing address phone:** (985) 492-9111
- **Mailing address fax:** (985) 492-9114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/22/2015
- **Last updated:** 10/22/2015