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Organization
ABUNDANT LIVING CARE ADULT FAMILY HOME
Active
Organization
ABUNDANT LIVING CARE ADULT FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIONDRA N BOHANON (ADMINISTRATOR)
(414) 403-9947
Entity
Organization
Contact information
Practice address
2721 N 18TH ST, MILWAUKEE, WI 53206-2135
(262) 478-0737
(262) 546-0749
Mailing address
PO BOX 18075, MILWAUKEE, WI 53218-0075
(414) 403-9947
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
01/22/2019
Last updated
07/28/2026
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