# ABODE CARE PARTNERS AL VB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SHC MEDICAL PARTNERS, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770808446
- **Legal business name:** SHC MEDICAL PARTNERS, LLC
- **Authorized official:** ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
- **Authorized official phone:** (502) 394-2100

## Contact information

- **Practice address:** 21412 GREAT MILLS RD, LEXINGTON PK, MD 20653-1203
- **Practice address phone:** (301) 863-7244
- **Practice address fax:** (301) 863-8550
- **Mailing address:** 12201 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2361
- **Mailing address phone:** (502) 568-7896
- **Mailing address fax:** (502) 568-7136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2010
- **Last updated:** 12/26/2023