# ABUNDANCE WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417633553
- **Authorized official:** HAZEL PHILLIP LCSW (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (551) 275-5674

## Contact information

- **Practice address:** 13732 THURSTON ST, SPRINGFIELD GARDENS, NY 11413-2637
- **Practice address phone:** (551) 275-5674
- **Mailing address:** 13732 THURSTON ST, SPRINGFIELD GARDENS, NY 11413-2637
- **Mailing address phone:** (551) 275-5674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2023
- **Last updated:** 06/23/2023