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Organization

ABUNDANT LIFE SUPPORT SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNY C SOTO LCAS-A (VICE-PRESIDENT)
(704) 771-5592
Entity
Organization

Contact information

Practice address
1193 JASMINE DR, INDIAN LAND, SC 29707-1504
(704) 771-5592
Mailing address
6416 REA RD STE B7, CHARLOTTE, NC 28277-4346
(980) 527-5600

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/04/2025
Last updated
11/04/2025
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